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Jul 18 02 08: 37a Elite Tv Contractors Inc 2094610342 p. 4 <br /> Elite IV Contractors Phone: (209) 461-6337 <br /> 2535 Wigwam Dr. Fax: (209) 461-6342 <br /> Stockton, CA. 95205 P.O.# / Work Order# <br /> PLACE IN SERVICE NOTICE O NOTICE OF SALE,LEASE, LOAN <br /> u ty Date Service Agency Registration No. <br /> 2278 <br /> LOCATION OF DEVICE <br /> Name of Customer Address y Zip <br /> n <br /> IATIGIIING OR MEASURING DEVICES PLACED IN SERVICE <br /> Cert of Cont No. Out of Order Device <br /> Manufacturer Model Number Serial Number Device Type (if device is new Capacity Tag Number Location <br /> and marked) <br /> I VY <br /> 1. �'����5�t •! `�' � l� <br /> '4, bib:S. bZis • 1 z r� <br /> Mo <br /> a 2G: <br /> Tags enclosed if applicable Date placed in service + <br /> ❑ <br /> G Date this notice was: Mailed <br /> ❑ Yes 11 No(if no explain in remarks) /l 7/ (D O -7I/� /0� <br /> 0o D k Faxed <br /> Print Name of Service Agent Sig a of Service Agent Service Agent's License No. <br /> � v SSG' �'� vn��G✓ D G O G� <br /> i <br />