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02/09/2010 11:31 FAX 916 371 2350 BZ SERVICE STATION 10007 <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: <br /> Address; <br /> Site Contact: <br /> Any spill at site: Yes oCN ere: <br /> Were all Lids bolted down and in place: Yes o�—rTo <br /> Are All Se s 1 Ye }'' �_--- <br /> Condition of Concrete and Asphalt: <br /> Were all spill buckets in place:(Y sir No <br /> Drums on site: Size a How y—L —Content/Labal: <br /> Any other problems to report: <br /> Upon Leaving Site <br /> Are all Lids bolted down and have bolts: Yes <br /> Are all Gaskets and Seals in place: Yes o1c <br /> Any Spills at Site: Yes of.& here: <br /> `Any thing else to be to report: <br /> Signature of Site Contact: <br /> Signature of Surveyor:,,, <br />