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B.Z. Service Station Maintenance, Inc. <br /> 630 Houston Street—P. O. Box 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: 11c, <br /> Site Name: ..t <br /> Address: <br /> Site Contact: <br /> Any spill at site: Yes 4�0l Vhere: <br /> Were all Lids bolted down and in place: Yes <br /> Are All Seals in-place: Yes orfi�To;Where: � - T <br /> Condition of Concrete and Asphalt: <br /> Were all spill buckets in place ` r No <br /> Drums on site: Size How many Content/Labal: 7. 14- <br /> Any <br /> Any other problems to report: e_-)=, r <br /> e' Upon Leaving Site <br /> Are all Lids bolted down and have bolts: Yes of" <br /> Are all Gaskets and Seals in place: Yes o <br /> Any Spills at Site: Yes Qf"ere: <br /> Any thing else to be to report: <br /> Signature of Site Contact: <br /> Signature of Surveyo:' <br />