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BNH BUSINESS FORMS 17141970.9025 <br /> bp WORK ACKNOWLEDGEMENT FORM <br /> 22J 0007$. I `� <br /> &MAINTENANCE TICKET NO. �j�q� DATE 3 J& -Z <br /> FACILITY NO.&ADDRESS f L(-4- T M,4pzA 1tvtJ <br /> CONTRACTOR COMPANY NAME <br /> SERVICE REQUESTED ON E-TICKET: 6805 Sierra Court, Suite G <br /> Dublin, CA 94568 <br /> WORK PERFORMED ONSITE(for prts replaced,provide part name(s),part number(s)&quantities,as applicable): <br /> ka� SNS E'f�-t�InN. �� Pvt V� <br /> I-Ni S Ti —I A/ Spy P�e7�S� �C�S w; i1yC-0 <br /> ARCO 7148 - <br /> 1206 E MARCH LN <br /> D;o 3 ' 1( iv 4-Z S70CKTON - <br /> INCON 03/16/2023 11:18 AM <br /> INCON INTELLIGENT CONTROLS INC _ <br /> INTELLIGENT CONTROLS INC F. 0. BOX 638 SUMP LEAK. TEST REPORT <br /> P. 0. BOX 638 SACO ME 04072 <br /> SACO ME 04072 1-500-984-6266 DSP 6 - <br /> 1-800-984-6266 <br /> 06/21/2007 12:18 AM - <br /> 06/21/2007 12:21 AM TEST STARTED 11:03 AM W SUMP LEAK TEST REPORT TEST STARTED 03/16/2023BEGIN LEVEL 17005 IN <br /> SUMP LEAK TEST REPORT CYU 3-),6-23 END TIME 11:18 RM <br /> SUM <br /> IF P 1 <br /> SUMP 1 FND DATE 03/16/2023 <br /> -eva aN '3-16-Z3 TEST STARTED 12:06 AM END LEVEL 3.8997 INLEAK THRESHOLD 0.002 IN <br /> TEST STARTED 12:03 AM TEST STARTED 06/21/2007 TEST RESULT PASSED <br /> TEST STARTED 06/21/2007 BEGIN LEVEL 5,2783 IN <br /> BEGIN LEVEL 4.9620 IN END TIME 12:21 AM <br /> I END TIME 12:18 AM END DATE 06/21/2007 - <br /> END DATE 06/21/2007 END LEVEL 5.2793 IN ARCO 7148 <br /> END LEVEL 4.9621 IN LEAK THRESHOLD 0.002 IN 1206 E MARCH LN <br /> LEAK THRESHOLD 0.002 IN TEST RESULT PASSED STOCKTON <br /> TEST RESULT PASSED <br /> 03/16/2023 11:18 AM <br /> ALVAL 1IME 'r DID YOU CHECK INTO TH SUMP LEVEL REPORT NO <br /> DEPARTURE TIME 3 •1 3 0 DID YOU CHECK OUT OF I SUMP DSP b3.8-9 c IN NO <br /> NO.OF PERSONNEL ONSITE <br /> ppwt1 <br /> TECHNICIAN NAME(PRINT LEGIBLY) SITE PERSONNEL(PRINT LEGIBLY) <br /> TECHNICIAN NAME(SIGN) SITE PERSONNEL(SIGN) <br /> DISTRIBUTION:WHITE-CONTRACTOR COPY /YELLOW-SITE COPY <br />