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RECEIVED <br /> SEP 142005 <br /> RBN;DE I'VER--TANF . REMOVE-TANK. SYSTEM TEST <br /> DEL NEW TANK WIWETLINE TO NEW TAMV SITE.F9.i OLD TANK., DG rJUA rNTY <br /> x-iri: •3�x-•tv fttarr -* !a•!t;: a:wa�ty3<Sr -##iey.;caacu�xc x-EE�tis x;. � # XSERVICi.;. <br /> WO# 549 LOSri0i2Yi03 13.20 <br /> AC0T#:443+ S#;1 DIV: i TYPE GQNE:022 13;32 21-Oct-G <br /> HEKINS PACIFIC BTORAC T'EL.a (209)443--6741 <br /> P 334 <br /> SrJCK -- <br /> TCF;TL7N.GA 05IR171-0334 SCYs ci PTX <br /> SAD: 8EKINS PACIFIC STIDR- 734 WILSHIRE AVE STOCKTON. CA 452010000 <br /> :SVC: INST: 807Y-94.3-6741 SCID MC, EP-4P-00. DP 200-642-6741, <br /> TANK SIZE: 284 SERIAL.#t 132314 LAST GAS C.HE:CK: NO 3A5 CHF: REC <br /> g .CODE- 'DESCRIPTA?NO D01.4 <br /> I�.. L... <br /> Lf 11003 <br /> '3L1ANDESCRIPTION_, <br /> .. . . <br /> ANS INT <br /> TIME IN TIME OUT I WAS TOTAL MATERIAL. <br /> TANKS YLINDER'IN'� TOTALLABOR <br /> SIZE sERIALNO. - %FULLMATERIAL.:LABOR TAX <br /> 13 GALLONS OF PROPANE® S <br /> TANKyCY'LINDER011T� . <br /> BALES I LOCAL/MUNI TAX <br /> NZSERIAL NO. c`xy ULL <br /> Cfff:CXHERE IFADVITI tNUALSHFE7E ❑ Lerdlt PAYMEttfTYP'E <br /> 7SNSINOLE5TAOE_ INYEORAL TIJOSTAGE_ TFRiEESYgGE—_ L:A5H ❑ M!Cr '• CHECK ❑ alsoSTART FINI '1 START rFINISH EQUIP.USED MAN I HP GAUGE1 OTHER <br /> MAN/ ER EgUIP.USED :�P GAUGE 0 PSI FLOWV16A ❑ AMEX <br /> TIME LOCKUP EXPIRES: <br /> C WC ❑PSI MANIFOLD MANIT310THER EQUIP.USED HE GAUGE EQUIP.USED MW/HP GAUGE/OTHER The undersigned: Knows how to tL <br /> 2Na TIME p y� SpW off the propane gee supply valVa <br /> TIME case of emergency, Has smell <br /> L!tl() r PSI rJ WC O PSI 0 PSI LOCKUP ompane and can detect its od <br /> MANIFOLD Understands the Settice tat h <br /> peen performed. Has read e. <br /> EQUIP.USED MAN/TBI OTHER EQUIP,USED HPGAUGE EgUIP.USED MAN/HP GAUGE/OTHER undelslands the above statements. <br /> 1IM TIME TIME _ 12 WO FLOW <br /> STAGE - — - <br /> CWC ❑PSI C C PBI LOCKUP r <br /> MANIFOLD __ i as�nrnar <br /> SERVICEWGNATURE 'Z1 Q"S <br /> PLEASE SEE REVERSE FOR IMPORTANT SAFETYAND BILLING INFORMATION Thank You? <br /> Item Number 1522513 4PR.5212 Rc. <br />