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09/28/2005 MON 11:06 FAX 0001/001 <br /> SB 989 TESTING PROGRAM <br /> by 1v: <br /> AGENCY NOTIFICATION SHEET +410' <br /> Notification Date: 3' Zg'C Notification For: <br /> Test DateMme: 3 30 - D s / '9', 00 A Initial Test: <br /> Repairs: <br /> RCO Fac#: 9600 Retest: <br /> Address: ZCO /\/ , W <br /> City: j+(D ClG '4th <br /> State: GA • To <br /> Agency Name-, U J� lr / OC- SC-n �J O Notification Method: <br /> Person Contacted: n O ti e✓�� _ Fax <br /> E-mail: <br /> pv fo`'t tt- Z o q, `{b S -3 N t(p Verbal: <br /> Testlaq Comments <br /> Testing will be performed on the date identified above to meet the SB 989 regulatory deadline. This notification <br /> is being provided to meet the 48 hour advance notice requirement. Upon completion of testing,results will be <br /> provided to your office as required. <br /> Contractor Namo: w a N X C <br /> Contractor Phone: �'l t -_ k� 9 �0 g0 <br /> Notification Made By: +� -- <br /> (Name of Individual) <br /> ARCO Contact: Phone: <br />