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10/22/2008 12:01 9163712450 BZ MANITANENCE PAGE 10/10 <br /> • <br /> S.Z. Service Station Maintenance, Inc. <br /> 630.Houston Street—P. O. Boz 933 <br /> West Sacramento, California 95691 <br /> Phone (916) 371-2380 <br /> Lic. #433159 <br /> Site Survey <br /> To be performed upon arrival <br /> Date: k" 171 <br /> Site Name: <br /> Address: 'N-5-5 Nr.,v 4 9 -� el x�,r <br /> Site Contact: rz; <br /> Any spill at site: Yes o Io-)Where: <br /> Were all Lids bolted down and in place Ye r No <br /> Are All Seals in.place.LY�r No Where: <br /> Condition of Concrete and Asphalt: 2 ; e <br /> Were all spill buckets in placQ XA"r No <br /> Drums on site: Size jj -. How many1 Content/Labal: IAz <br /> Any other problems to report: A,16 <br /> Upon Leaving Site <br /> Are all Lids bolted down and have bolts .Y-" No <br /> Are all Gaskets and Seals in placi��Y , br No <br /> Any Spills at Site: Yes ¢Y No}here: <br /> Any thing else to be to rep rt: <br /> s. <br /> Signature of Site Contact: ,:: <br /> Signature of Surveyor: ' - <br />