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9255517888 Line -2:31:57 01-08-2013 1VARECEfi <br /> r <br /> GETTLER R, PIN <br /> 0 V L�Oij <br /> SAN JOAQUIChn N COUNTY <br /> TESTING NOTIFICATIONJob# 20-583006 HEALTH DER q ENTAL <br /> Notification Date 1/8/2013 <br /> Requested Test Date 1/22/2013 Requested Time: 10:00am <br /> Facility Name Arco 6080 Repairs Requested FAI <br /> Facility Address 85 East Louise Ave Startup Test ❑ <br /> Cit /State Lathrop,Ca. Annual Test ❑ <br /> Agency Notified San Joaquin County EHD Method: <br /> Contact Person Inspector Verbal ❑ <br /> Telephone: Fax ❑x <br /> Fax: 209-468-3433 E-Mail <br /> Testing Scope(check all that apply) <br /> Tank Monitor Certification: ❑ VR201-202 Exhibit 5 ❑ <br /> Spill Bucket: ❑ VR201-202 Exhibit 7 ❑ <br /> Secondary Containment(SB989): ❑ VR201-202 Exhibit 8 ❑ <br /> Test s12 sensor <br /> 3GPH Simulation: ❑ VR201-202 Exhibit 9 ❑ <br /> TP201.1 B ❑ VR203-204 Exhibit 5 ❑ <br /> TP201.1C/D ❑ VR203-204 Exhibit 6 ❑ <br /> TP201.1 E ❑ VR203-204 Exhibit 8 ❑ <br /> TP201.3 ❑ VR203-204 Exhibit 9 ❑ <br /> TP201.36 ❑ VR203-204 Exhibit 10 ❑ <br /> TP201.4 ❑ VR203-204 Exhibit 11 ❑ <br /> TP201.6 ❑ VR203-204 Exhibit 12 E] <br /> Healy Dispenser Integrity❑ VR203-204 Exhibit 13 <br /> VR201-202 Exhibit 4 ❑ VR203-204 Exhibit 14 ❑ <br /> Repair Scope: replace s12 sensor and retest <br /> Technician Assigned to:Wes Morrison/Thomas Welch 916-826-3032 <br /> Notification Contact: Ryan Matthews Contact Phone#: 926.551-7555 or 916-826-6806 <br /> GEITLER-R3'AN INC. Office - 925-551-7555 Fax - 925-5514770 email - b maint@grinc.cont or rmatthews@grinc.com <br /> � a; <br />