Laserfiche WebLink
UE <br /> ' AFMANE SAISTJO5c,LUFOINI A 95 1122WELLEEEA-r' `SPECON CBECKLIS <br /> 7rm'SaFmf-- - <br /> (408)"T3-moi FAX Client <br /> JJ (408)573-05-5 PHMIE 1 - <br /> hSfte Address LO <br /> 2 <br /> i erilrlici-an <br /> `t Date [ 1 - [- D 0 <br /> 1.Isd an box? S_ Casino seane? I2. Water staroaro in vveflbox? 15.Wetl rba funcdor W7 <br /> 2 Lid broken? ?. Casi m art level? 122-Staudino above the tan of casina? 16_Can tap be puff lease? <br /> 3.Lid baits missing? a. Debris in wellbox? 12h.Stmdlno below the top of casino? 17.Can r ao semi out vr.-Mr? <br /> A.tad baits sirippea. 9. Weiibox is toe far above arnde? I Water even with the top of casino? 18. PROlock present? <br /> 5. Lid seal intact? 10.Weffbax is*a far below grade? 13. Wei cap present: 19.Padlock funcianaP <br /> 11.Wellbcx is rrushedhfamaaed? 19. Weft can found sa-_..rte? <br /> 0 Check box if no deficiencies were found. Note below deficiencies you were dile to correct. <br /> Welt I.D. Deficiency Corrective Action Taken <br /> AV-1 ^Cdi 4av Y./ ci <br /> i <br /> Note below all deitencies that could not be corrected and still need to be correcied. <br /> BTS ice assigns_or Dale Date <br /> Well I.D. Persistina Deffciencv defers Correction to: assigned corrected <br /> • s i <br /> A•I i i <br />