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RECEIVED <br /> LEAK DETECTION 11\ N 17 2018 <br /> F\, t ! 11 I 0 t F ENVIRONMENTAL HEALTH <br /> Exclusive Providers for MDleak�� and PHDleak� Technologies DEPARTMENT <br /> 1889 North Oiacic Road I n , sun , � '/, t� S __ 115 P11 ( inc 555 - ? 55 `� '� ' 5 I " , � \ : 5 _' ll . �) r ?11. S9GS <br /> : <br /> SnlcsGr I ( Aakl ) ctcct . net • v%vwxv . 1 .( ikl ) ctcct . nct <br /> Signed Non - Disturbance Post ELD Contractor Statement <br /> Reference : <br /> Arco AMP <br /> 1329 Escalon Ave , <br /> Escalon , CA 95320 <br /> Contractor : <br /> License #901865 <br /> Business Name : E M P E <br /> City : COMPTON <br /> Per the office of the State Water Resource Control Board , we are required to provide a <br /> signed agreement ( below) , which states that there is to be no alterations to the site once we <br /> have completed our Final ELD Testing . <br /> The state requires us to have this statement signed and returned to us prior to our arrival on <br /> site to complete the Final ELD Testing . <br /> LDT has completed this form , and once it is signed and returned to our office , we will notify <br /> the appropriate department at the State Water Resource on your behalf . <br /> Please sign and date below . <br /> Thank you ! <br /> Statement : No further ground penetrating work, including beautification requirements , atop <br /> or immediately adjacent to , the UST system are needed or will be performed <br /> after the Final ELD testing is performed at the above mentioned location . <br /> Contractor Signatur __ Date : ` <br /> Print Name : � �'�L eZ) <br /> Author- c w r; rrdo Percdcs 1of 1 <br />