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0 <br />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: <br />Site Name: cn,, u, _(3. <br />Address: <br />LIZ', <br />4 <br />Site Contact:, <br />Any spill at site: Yes ori -o) Where: <br />Were all Lids bolted down and in place: Yes o`No <br />_..Are All Se is lilac X.14" <br />Condition of Concrete and Asphalt: <br />Were all spill buckets in place<Y.br No <br />Drums on site: Size -L5 <br />_How many_-Content/Labal: <br />Any other problems to report: 1 <br />r <br />Upon Leaving Site <br />Are all Lids bolted down and have bolts: Yes o%1a-' <br />Are all Gaskets and Seals in place: Yes or; jo <br />Any Spills at Site: Yes or NPVhere: <br />'Any thing else to be to report: <br />Signature of Site Contact: _.._..._.._._......_ - , <br />i Signature of Surveyor:-- <br />