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05/11/2010 09:13 FAX 910 971 2380 BZ SERVICE STATION Z 001 <br />0 novl'g?d o3/I/I0- <br />------------------------------------------------------------� -V55 <br />K SERVICE STATION MAINTENANCE INC <br />MAR 11 2010 <br />916-371-2380 FAX916-371-2540 ENVIRUIVIvItNTHEALT4 <br />PERMIT/SERVICES <br />Fax form back for confirmation of appointment. <br />TERRI FOX bzss1Patta/obal.net <br />MONITORING SYSTEM CERTIFICATION <br />Attn:�/ 1Y 15 �c iCcCl I ST, C�/ L /✓1V <br />Fax; <br />A test has been scheduled at the following location: <br />Station Name:{ I 1 �/ 1�i I ' n <br />Station Address: f �� w ' � , J 6 Y '/�� <br />Testing will be conducted on begin ' at <br />The following test will be conducted: <br />• Inventory of Equipment Tested/Certlf d <br />• Line Leak Detectors <br />• Vacuum/Pressure Monitoring (If ap Ilcable) <br />• Spill Bucket Test <br />Compliance Test Post Construction <br />To confirm Date and Time, please indicate Inspector name below: <br />If no inspector will be on site please check <br />Please contact us immediately if you need to cancel or reschedule. <br />9" 3�) "�J'1 <br />