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6-26-05; 9:50AM;Secramentc EMC ;916 92G2616 # 5/ <br /> SACRAMENTO EQUIPMENT MAINTENAN•COMPANY,INC. • (916-925-2716)(916-925-2816 fax) <br /> 2533 Connie Drive CA Contractors'License#502377 <br /> Sacramentd,CA 95815-2809 Federal ID#68-0110167 <br /> Customer Job Location we#119309-2 Work Order# <br /> 7-Eleven,Llc. 7-Elevt$N 321%/1 Chevron W301607 Date Received: <br /> 96 Jeff Simonson 4943 South State Rotate 99 Arch Road OS-12- <br /> 2339 Child Meadow Way#101 Stockton,CA 95602 Contact: Keela <br /> Gold River,CA 95670 209-939-0679 Customer PO# <br /> 050511123-41 <br /> 800-828-0711 2235!307 <br /> Station# <br /> Work to be Performed: o not remove: Veritonti RUDYiQlIcyrou <br /> PI-Thursday-#516 shear valve emergency fuel in dispenser pan;see Inspection lift liO&L11-OS is pm sr-Lee to follow up <br /> }VOTIr Performed ` p� 1+ 1 EQ to G,Mc MI, Madel Serial . <br /> K C oG, <br /> l C} rtc c '/f r rr <br /> lfi r.J 's Isc 'tc- 20 -; >1 .�.� 4 srP f+1•t 5}cnd,n t�N.d <br /> e :1 r;l< rev-A ..e _ 'Ll. ' <br /> ` Clean 313 A,."A e e i :s <br /> 1/1 � <br /> 3 GN/ �} ` f I 6•C/561— 412 / �a/IPh <br /> CL y- e <br /> BendtngProbiGms.�' sac/-a ct-n r /.:.. r �4 5776 <br /> o-w lie S <br /> r'e.n OL Y>-✓ e�i-S GAS � RS Au.�lr �xC $I.0 r 4.�t/ <br /> Qy Pvaq Mfg nnc New Snulk Cart Panty Cassa ft P.Qm Fault Con Min <br /> nwc Tech Oa Siti:TSme Store Stamp&Signature <br /> 'Initials '. <br /> 'Arrival Depamare <br /> Chevron ID ' JO'i! fi7 <br /> SR <br /> 95215 <br /> Office Use Only: <br /> r <br /> Signature: //Print Name: - lw/r/ GY V <br /> Subject to terms an nditions on back hereof: <br /> Data Entered? Yes❑ / Notice:A Finance Charge of 1 1/2% r month,which is an annual pereenaage rate of 18%,will be <br /> MOB Yes❑ 1111�OyJ charged on past due accounts over 30 days. Contractors are required by law to be licensed and regulated <br /> W+M Report Needed? Yes❑ No by the Connactor's State License Board. Any questions concerning a contractor ma be referred to the <br /> Monitor Report Needed Yes❑ _ _ No Registrar of the Board whose address is: Contractor's State License Board-9835 Geothe-P.O.Box <br /> Jab Complete Yes 0 No 260011,Sacramento,CA 95826 <br /> White(Emc)// Blue(Emc Pending) // Green(customer copy) <br />