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9255517888 Line 1 45 <br />8:46 p.m. 10-06-2008 <br />AM RE <br />&E T TL ERawYA N ® 'cD <br />0L <br />SAN JOAQUIN COUNTY <br />ENVIROINENTAL <br />HEALTH , p OTA—... <br />TESTING PROGRAM <br />AGENCY NOTIFICATION SHEET <br />Aotification D a t e: /&IF <br />quested Test D, <br />-acifity Name --A <br />llite-Name Facility #: o2 <br />A <br />State: <br />Person: <br />Testing Scope thecksu components thatappy) <br />ST -27 Back Pressure/TP 201.4 <br />ST -30 PSI Decay USI TP 201.3 <br />ST -37 Liquid Removal/TP 201.6 <br />ST -38 PSI Decay ASf TP 201.3B <br />ST -39 Air/ Liquid/ TP 201.5 <br />REPAIR SCOPE (desclibe componenats and antkipated mpairs) <br />Notification Contact: <br />Scope of Work Contact: <br />W/O#: <br />Notification For: <br />Initial Test <br />Repairs <br />Re -Test <br />�Mw <br />Method: <br />Verbal <br />Fax <br />E -Mail <br />Confirm Date/ Time: <br />Tech: <br />Tank Monitor Certification <br />3-GPH Leak Simulation <br />Static Tifirque TP -201.1B <br />Drop Tube/Drain Valve TP 201.IG <br />Drop Tube OVERFILL TP -201.1D <br />7 57W <br />Telephone: (925) 551-4777 <br />Telephone: <br />Sierra Ontirt. Ripitp. .1 - Dahlin r, n I i fn r m io 0A GFA . I C1 1) al = C 1 7 C C C <br />qo <br />�6p% <br />