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Afforda-Te$t -Work Date <br />416 2nd Street Galt, Ca 95632) 01 7 Tech: <br />"1 <br />209 744-0112 <br />Site: <br />-Monitor t I El' -MVprRecovery Tank&/Lines <br />toro� <br />Alarm Response / Lbr / Other <br />W <br />No Parts Needed <br />� 1 Parts Replaced: <br />Lid Bolts: OK # Missing or Stripped 6 ou'), <br />Site Representative (print): <br />Site Representative Signature: <br />*Any issues within a few days of testing could be related to this testing, so site must call us BEFORE maintenance repairs are done by others. <br />t ..I <br />Afforda-Te$t - Work Order Date A <br />416 2nd Street Galt, Ca 95632 <br />209 744-0112 <br />Site: i <br />VICM�� <br />Site Representative (print): <br />