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1-5517888 Line 10:55:34 10-02-2013 <br />6E r rL ER - KJ'F 'EYA N INC. RECEIVED <br />91 <br />OCT 2 W <br />NOTIFICATION Job # <br />Notification Date 10/2/2013 <br />Requested Test Date 10/9/2013 Requested Time: 9:00arn <br />Facility Name Arco 6450 Repairs RequestedEl <br />Facility Address 1617 W Fremont Startup Test <br />City/State Stockton Annual Test <br />Agency Notified San Joaquin County EHD Method: <br />Contact Person Stacy Rivera Verbal ❑ <br />Telephone: Fax 51 <br />Fax: 209-464-0138 E -Mail <br />Tank Monitor Certification: <br />Spill Bucket: <br />Secondary Containment (SB989): <br />3GPH Simulation: <br />TP201.1B <br />TP201.1C/D <br />TP201.1 E <br />TP201.3 <br />TP201.3B <br />TP201.4 <br />TP201.6 <br />Healy Dispenser Integrity❑ <br />VR201-202 Exhibit 4 <br />Inspection of • <br />- ,K . U !" <br />VR201-202 Exhibit 5 <br />VR201-202 Exhibit 7 <br />VR201-202 Exhibit 8 <br />VR201-202 Exhibit 9 E] <br />VR203-204 Exhibit 5 <br />VR203-204 Exhibit 6 Fj <br />VR203-204 Exhibit 8 <br />VR203-204 Exhibit 9 <br />VR203-204 Exhibit 10 <br />VR203-204 Exhibit 11 <br />VR203-204 Exhibit 12 <br />VR203-204 Exhibit 13 <br />VR203-204 Exhibit 14 <br />Scope: Inspection of sensor replacement SR0067984 <br />Technician Assigned to: Joey Mesa 916-826-3032 <br />Notification Contact: Wendy Beach Contact Phone #: 925-551-7555 <br />fD <br />TAN INC. Office - 925-551-7555 Fax - 925-551-4770 email - grmaini <br />Received Time Oct. 2. 2013 10:49AM No -4195 <br />