Laserfiche WebLink
Trak Qad Monitor Sucaaa�ry <br /> Location Pacific Bell Ccolpu-,41 UE-R47 <br /> Address 4051 Newton Road CLLC:_ Sj(jD1C1� 6 <br /> City Stockton Tank d 2f)2q <br /> Caunry San Joaquin T", Pcrrnii 0nn} nnted b�' ++"�Rh_ <br /> Zip Expira600 Date <br /> lnspe¢tioa Record <br /> tnOrmgrouod S(on+`c Txok <br /> Tank Siu: 10. OOOProducunleadeducllcvclC :cst8180 dal, 71 . 92 Monitor 72 . 0 Stick <br /> Agency mquisingCcrciftoa6= San Joaquin Health <br /> Agcaq sigpu;uLm U/A roquirod to be ou sttc? no <br /> Required Testing: Teak: no Anne! Anriwily Liow: no Annuar' — A.laually <br /> Tcsiing Fermis Rcquircd 1'cs x No <br /> Test Type: <br /> Test Date: <br /> Tcst Performed By; Company See below <br /> Conta;.t' <br /> Phonc Nusn'txr <br /> Tested t3� IiGCRS� � <br /> Tcst Results; Pass/ Fail <br /> Remarks;, 2ol112l e wall taak and lin 1`�n._,ta�f i na rf-Lju i r�rl <br /> at this time --_� - - - --- <br /> .�+i001:0i�Ag 51`54Ca3 <br /> Mauulacrwcr; Veeder Root Model: TT,S— 50 <br /> Agency Requiring Ccruficauon Same <br /> Agency Signature: NIA Rcquircd to be on site? no <br /> Required Scrai-Aju)ual Arr:ualiy <br /> Testing Pc=t Rcquul; Yes x ilia <br /> TmTypc; Annual monitor cer <br /> Test Data: 8-29-96 <br /> TwPcrformcdBy', Con,,p,%ns- DIALYSIS COMPANY <br /> Cor:a.;. James or Tamara Zimmerman <br /> Pho.nc 800 227-7879 <br /> Tested 5) James Zimmerman <br /> Test Results: pass Pass / Fail <br /> Ramu s: PanpI more anr3 sensors were ff1u;W 1t1_kDp <br /> functioning as oer manufacturers spec'ifiratinnc, <br /> Cleaned thg QvQLspill wpl1 _aud summa Un exterior alarm <br /> �presen <br /> Date of Next Test . 8-9_ <br /> Serial : 41232517605001 <br />