Laserfiche WebLink
9255517899 Line 1 E T T PER - I'f YA N INC. 4 a.�� ' '°_03_2°,° „ <br /> OCT0 b 2010 <br /> TESTING PROGRAM <br /> AGENCY NOTIFICATION SHEET W/O g; t <br /> Notification Date: O� it) Notification For: <br /> Requested Test Date: 1 • I� /y j Repairs <br /> �jL(%,, I�XXF, Initial Test <br /> Facility Name: 1' Re-Test <br /> Site Name''II Facility#: <br /> Address: `t 4"'I <br /> City,State:z�bC n <br /> Agency Notified: 3D-n_73hcL&ul n 0_ n4-(4 y_,n V Method: <br /> Contact Person: KI — 1—` Verbal <br /> Fax <br /> Telephone <br /> Fax All - ,- 0 '�( r3 . E-Mail <br /> . <br /> Testing Scope(check all components that apply) <br /> TP-201.4/ST-27 Back Pressure r-� Tank Monitor Cert/Bucket Test <br /> TP-201.3/ST-30 PSI Decay 3-GPH Simulation <br /> TP-201.6/ST-37 Liquid Removal TP-201.1a.StaticTorque <br /> TP-201.38/ST-38 PSI Decay AST Drop Tube/Overfill TP-201.1D <br /> TP-201.5/ST-39 Air/Liquid Secondary Containment ---- -.-- "--"""" --- <br /> Repair Scope O L q <br /> P 9A dA <br /> Notification Contact: Telephone: 925-531-4777 <br /> 6747 Sierra Court, Suite J • Dublin, CA 94568 • (925) 551-7555.• Fax (925) 551-7888 <br /> 3140 Gold Camp Drive, Suite 170 • Rancho Cordova, CA 95670 • (916) 631-1300 - Fax(916) 631-1317 <br /> 1364 N. McDowell Blvd., Suite D2 • Petaluma, CA 94954 • (707) 789-3255 • Fax (707) 789-3218 �� <br />