Laserfiche WebLink
Oct 1911 10:35a BZService 91 20150 p.1 <br /> K <br /> 4 , <br /> B.Z. OCT 9 <br /> SERVICE STATION MAINTENATS <br /> Phone: 916-371-2380 Fax: 916-572-0150 <br /> Email: fox cr,wavf.cship cam <br /> ** Fax or email form back or eon ruination o a orntfnerat**� <br /> Environmental Health (Secondary Containment) <br /> Attn: � � <br /> 2 Date: <br /> Fax or emaiT- =7 j 3 <br /> A Secondary Containment test has been scheduledat the following location: <br /> Station Name: <br /> Station Address: �= <br /> Testing will be conducted on: beginning at— <br /> Th e <br /> tThe following tests will be conducted(if applicable): <br /> ➢ Track Annular Testing <br /> Secondary Pipe Testing <br /> ➢ <br /> Piping Sump Testing <br /> > Under Dispenser Contahunent (UDC Testing) �C 3 f j <br /> ? Fill Riser Containment Testing V �" <br /> ➢ Cathodic Testing ' �(�� 5�3 7 <br /> 07 <br /> --u.--" Compliance Test Post Construction <br /> Authority# <br /> * *Please confirm.bate and Time and indicate inspector name below <br /> If no inspector on site please check <br /> Please contact me intmediately if you wish to cancel or re-schedule. Thank you. <br />