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03/28/2005 MON 11:07 FAX 12001/001 <br /> z <br /> SB 989 TESTING PROGRAMbp �;�♦`�r <br /> rr I <br /> AGENCY NOTIFICATION SHEET .10,;0 tip <br /> Of <br /> Notification Date: 2 91 -- 0 Notification For: <br /> Test Date/Time: T -3 () S--/ -7UQ ✓j Initial'fest: _ <br /> Repairs: <br /> ARCO Fac#: 6 o qd Re-test: <br /> Address: S U.� V <br /> City: -- <br /> ate: Co., <br /> Agency Name: Ott—" CJ L/�r✓\ Notification Method: <br /> Person Contacted: 6 v` A Fax <br /> p E-mail: <br /> ` V "v L' 'tk-- C2q`�� ''� (o KK (p Verbal: <br /> Testing 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 Name: _ C- e f r` C <br /> ontractor Phone: 1�75 <br /> Notification Made By: a �' � <br /> (Name of Individuate <br /> CO Contact: Phone: <br />