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CG CG <br />Q <br />LEAK DETECTION H-POVICE-9 <br />GENERAL CONTRACTOR ACKNOWLEDGEMENT <br />Effective 05/26/15, the State Water Resources Control Board now requires a signed statement from all <br />general contractors prior to final ELD testing. <br />By signing below, the.general contractor acknowledges that: <br />"No further ground penetrating work, including beautification requirements, atop or immediately <br />adjacent to, the UST system are needed or will be performed after ELD testing is performed."4-itF ,-4-*',.+1;-tc z, Fes, t, - <br />L ->c -Alm <br />General Contractor Information <br />Company Name/CA License #: McCarthy Building{ompanies/411173 <br />Contact: Steve McBride <br />Address: 2241 Douglas Blvd. #200, Roseville, .CA 95661 <br />Telephone/Email: 916-501-0018/smcbride@mccarthy.com <br />Site Information <br />Site Name: San Joaquin Regional Transit District <br />Address: 2825 E. Myrtle St. #B, Stockton , CA unknown <br />Telephone: 310-323-3155 <br />County: San Joaquin <br />CUPA Contact: Garret Backus; Robert von Flue <br />CUPA Phone/Email: 209-468-2986/gbackus@sjcehd.com; rvonflue@sjcehd.com <br />Testing Company Information <br />Name: CGRS, Inc. <br />Technician Assigned/License #: Sergio L. Nunez/#06-1727 <br />Signature <br />General Contractor's Signature: Cv <br />Name (print): <br />Title: �-� 4rn �-4>ce- Date of Signature: S l <br />5444 Dry Creek Rd: Sacr"oirienio, CA 951M T 916.991.1100` 006-9011-107 Vimcgra.com <br />. qEc <br />VEE <br />AUG 0 Zt�1 <br />