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z»3 uonme unve - /�- <br /> Sacramento,CA 95815-2809 ON 3.2f-- 4/19Y, Fed e..IID#68-0110167 <br /> Customer Job Location we#1]20796-1 Work Order# 120798, <br /> Fmii'sTexaco Eml!'sTesato / Dahlteceived: na Ratar�av�ia <br /> Chacko Thrrnas ChatlraThdmas --x— .,- <br /> 1405 California Ave 1405 California Ave Contact <br /> Escalon,Ca 95320 Esealon,Ca9=0 Customer PO# 9t ee8' <br /> 109.838-76783 <br /> 4 309- 8-7674 20-4a4-W29�n C F IL sa station# emastex <br /> Work to be Performed: 31:' Confined Space site-2 Men or 1 Ria9 <br /> Wa_tsprtce ou @n Enoon grtnnrrsfor G-dte twel <br /> Work Performed:.. - Bora trod: Mrs Maas saw <br /> V15 til Jt.•/S.K � S <br /> i A C411 <br /> S S �r, �� (_ r/ <br /> r/ -)r,h (,4 0, J <br /> f/ t <br /> n � t <br /> Pending Problems: <br /> s 'e <br /> Parts Used <br /> Qry I'anrc Mfg Doc New gawp Cam Pair Com Srnal It EOID fault Canqa .Amon <br /> Lit <br /> Tech On SiteTime Store Stamp&Signature <br /> Initials <br /> Amval Deparnve <br /> r` <br /> Office Use Only: <br /> Signattug; 1 //Print N <br /> SubjMIl tlt/too terms and con icons on back hereof <br /> Data Entered? Yes❑ Notice::Rqmm <br /> ance Charge of 1 1/2% month,which is an annual rage rate of I8%,will be <br /> MOB Yes o chargedast d Needed? Yes❑ No ❑ by the ctorntor Report Needed Yes❑ No ❑ Registrhe HJobComplYek No ❑ 26000, rtenm,CA 95826 <br /> White(Erne)// Blue(Erne Perding) // Green(customer copy) <br />