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B.Z. ervice 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: ('L- 2 9 - 0 G <br />Site Name: <br />Address: NTO <br />Site Contact: <br />Any spill at site: Yes or& Where: <br />Were all Lids bolted down and in place: G orl1 <br />Are All Seals in place: `es or(&) Where: <br />Condition of Concrete and Asphalt: <br />Were all spill buckets in place: Q or No <br />Drums on site: SizeS--How many Content/Labal: <br />Any ether problems to report: I LA c e 6 a U� <br />Upon Leaving Site <br />Are all Lids bolted down and have bolts: (9 or Uo <br />Are all Gaskets and Seals in place:rQ YSO <br />Any Spills at Site: Yes or(fo Where: <br />Any thing else to be to <br />Signature of Site Conta <br />Signature of Surveyor: <br />