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ALARM HISTORY REPORT (P3-2) <br />WALroN___�_ <br />ENGINEER G� ;rye. <br />P. O. Box 1025 <br />3900 Commerce Drive <br />West Sacramento, CA 95691-1025 <br />9163721888 PH <br />9163731172 FAX <br />CA Contractor's License # 617238 <br />Customer Job Location <br />Work Order # <br />100153 <br />Quik Stop Markets, Inc. Quik Stop Markel #138 Z1 <br />Scheduled Date: <br />8/9/2017 <br />Enterprise Street 1153 Lincoln Blvq. <br />Time: <br />Scheduled me: <br />9:00:OOAM <br />Fre <br />Fremont, CA 94538 Tracy, CA 95378 <br />Contact: <br />Michael Karvelot <br />Reason <br />Customer PO# : <br />170002 <br />Phone: 20983284 <br />Facility: <br />W31020-138 <br />Cap, Fill, PW <br />Swivel Adapter - Fill, EVR <br />Sensor, Sump 7 <br />Station #: <br />138 <br />Date <br />Contract # <br />iva <br />Annual Compliance Test <br />8/9/17 JSA completed prior to start of work. <br />8/9/17 Performed Monitoring certification with passing resuns. <br />Replaced fill cap and swivel adapter on 87 tank due to +eaks during SC testing, <br />91 STP 208 sensor fell apart white moving and required replacement. <br />Placed test water in liquid hazardous storage drum, Cgntent level Full. <br />Parts Used: <br />Qty <br />Part # <br />Mfg <br />Mfg Part 4 <br />New Serialesc <br />Reason <br />1 <br />1 <br />1 <br />01-14011 <br />301-13011 <br />304-10208 <br />PW <br />OPW <br />V -R <br />-7 <br />61 SALP-1020•EV <br />794380-208 <br />na <br />na <br />1219581 <br />Cap, Fill, PW <br />Swivel Adapter - Fill, EVR <br />Sensor, Sump 7 <br />ormal Wear <br />ormal Wear <br />ormat Wear <br />Date <br />echnician <br />iva <br />Departure <br />ate ec nide, <br />ArrivalDeparture <br />19/17 <br />1 Beall; Scott J. <br />07% <br />13:26 jptu= <br />moraies7-7n-dres <br />9:06 13:26 <br />OCT 202017 <br />ENVIRONMENTAL HEALTH <br />Store Stamp & Signature <br />I <br />echnician. Signature Customer Signatu <br />0 2017 W ^---7— <br />, ;::"' Page 4 Alarm history - 2 <br />