Laserfiche WebLink
EA <br /> UEL <br /> Environmental Compliance,Maintenance & Construction <br /> - WORK ACKNOWLEDGEMENT - <br /> DATE DISPATCHED <br /> FACILITY# ARRIVAL: <br /> ADDRESS 7?'73 we f 4-q-i •C DEPARTURE: <br /> CITY STATE 5fo C 0i C /. LABOR HRS: <br /> COUNTY TRAVEL HRS: <br /> SITE CONTACT d 1 TECHNICIAN(S) <br /> PHONE# ,U" <br /> SERVICE PERFORMED <br /> ❑ TANK TIGHTNESS TEST `b MONITOR CERTIFICATION ❑ ENVIRONMENTAL REPAIR <br /> ❑ PRODUCT LINE TEST +❑. FACILITY INSPECTION ❑ LEAK DETECTION TEST <br /> ❑ VAPOR RECOVERY TEST OTHER <br /> ,,pprr SERVICE DESCRIPTION <br /> LCA A,1711 c e //Q Ccr <br /> T o-##: <br /> AUTHORIZATION#: <br /> PARTS <br /> QUANTITY DESCRIPTION QUANTITY DESCRIPTION QUANTITY DESCRIPTION <br /> 1. This work acknowledgement constitutes a contract. <br /> 2. Interest will be charged at the rate of 1.5%per month after 30 days if the invoice is not paid. <br /> 3. If legal action becomes necessary to enforce collection of this account,client will be liable for attorney fees and court costs <br /> CUSTOMER SIGNATURE: . _ DATE: J 1 ' � <br /> NAME (PLEASE PRINT):_ <br />