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SERVICE/REPAIR AUTHORIZATION SERVICE/REPAIR AUTHORIZATION <br /> # IT <br /> apoMom 8ERWOCIE ccr(om WNWHOE <br /> (ow <br /> MOM EWUMIEIN\�V 00.09HQ VaToom CRMO' IEW c(onoHQ <br /> CALIFORNIA CONTRACTOR LICENSE 309105 A-C61ID40 HAZ CALIFORNIA CONTRACTOR LICENSE 309105 A-C61/1340 HAZ <br /> Sea K UNION ST.STOCKTON,CALIF.95205 WS N.UNION ST.STOCKTON,CALIF.95205 <br /> I' <br /> P.O.BOX Lft STOCKTON,CALIF.95201 P.O.BOX 608 STOCKTON,CALIF.95201 <br /> PHONE 209/464-8333 PHONE 209/464-8333 <br /> SALES SERVICE • INSTALLATION OF PETROLEUM DISPENSING • LUBRICATION&INDUSTRIAL SERVICE EQUIPMENT SALES SERVICE • INSTALLATION OF PETROLEUM DISPENSING • LUBRICATION&INDUSTRIAL SERVICE EQUIPMENT <br /> P.O.# DATE P.O.# DATE <br /> I Li—1-s-0 <br /> COMPANY NAME <br /> M -AA <br /> COMPANY NAME AUTHORIZING NAME LL <br /> Ct,se c) Iry <br /> AUTHORIZING NAME <br /> BUSINESS ADDRESS ST. BUSINESS? IADDRESS ST. <br /> LOCATION " - <br /> G oXv-Q- A-u-c - LOCATION To®I ?c-a- <br /> CITY ZIP PHONE CITY ZIP PHONE <br /> 's -T .5fafekicni <br /> 777- <br /> 1-0- <br /> uvc-r ruso Po,4*1+ P-01&44.- 6J LCAAC bjd-�LltWa,.j <br /> Puls-c-r au+-ed -14c" L4ak LO (R.U.) 42-or <br /> 1f.�a Aj is-w 'o-a I-(a i-4-j s-,rw-vtl rv*Cs, k t irdtr le.4ic N&EccAur At&i-4 A ig L0 ea <br /> IV 94,m-o W-c- c b <br /> m rdlol"Ap A. <br /> bth-Ay: j"E"*-0 lvil-d A/ Z 4-.fcD e,i-r� MAY 2 3 2002 <br /> +Ari-cd- 7e6O- Dk- &4- :96i Plic lopa Le.,k ENVIROWENT HEALTH <br /> PERMIT�SERWES <br /> IH I E I R I EBY,I A( RIZETHEREPAIR/SERVICEWOFtKTO BE DONE BY STOCKTON SERVICE STAT I IONEQUIPMENTCOMPANY I HEREBY AUTHORIZE THE FiEPAIR/,SiRVICE WORK TO BE DONE BY ST I OCKTON SERVICE STATION E I QUIPMENTCOMPANY <br /> INC.AS DESCRIBED ABOVE ON THE EQUIPMENT NAMED HEREON.ALL REPAIR PARTS ARE TO BE BILLED AT S.S.S.F INC.AS DESCRIBED,ABOVE ONTHE,EQUIPMENT NAMED'HEREON.ALL REPAIR PARTS ARE Ta BE BILLED AT S.S.S.E. <br /> REGULAR PRICES.I AGREE TO PAY CASH FOR SUCH REPAIR PARTS AND LABOR ON DELIVERY OF EQUIPMENT OR ON REGULAR PRICES.I AGREE TO PAY;CASH FOR SUCH REPAIR PARTS AND LABOR ON DELIVERY,OF EQUIPMENT OR ON <br /> TERMS SATISFACTORY TO S.S.S.E AND UNTIL PAID IN FULL ANY UNPAID BALANCES SHALL CONSTrrUTEA LIEN ON THIS TERMS SATISFACTORY TOVS.S.S.E.AND UNTIL PAID IN FULL ANY UNPAID BALANCES SHALL CONSTITUTE A LIEN ON THIS <br /> EQUIPMENT.'I FURTHER AGREE THAT S.S.S.E.WILL NOT BE HELD RESPONSIBLE FOR LOSS OR DAMAGE TO SAID EQUIPMENT.I FURTHER AGREE THAT S.S.S.E.WILL NOT BE HELD RESPONSIBLE FOR LOSS OR DAMAGE TO SAID <br /> EQUIPMENT FROM FIRE,THEFT OR OTHER CAUSES BEYOND S.S.S.E'S CONTROL" EQUIPMENT FROM FIRE,THEFT OR OTHER CAUSES BEYOND S.S.&E-S CONTROL <br /> I AGREE,TO BE INVOICED AND WILL BE SUBJECT TO TERMS. I AGREE TO BE INVOICED AND WILL BE SUBJECT TO TERMS. <br /> AUTHORIZED SIGNATURE TITLE AUTHOPIZ�A5GNA E TITLE <br /> x X. <br /> FORM#0015 OFF!l-F C-)PYFORM 90015 y <br />