DERR-2024-008425

BILLING ADDRESS FACILITY ADDRESS
WORK ORDER # DATE:
CONTACT: DEQ ID#
APPLIED ENVIRONMENTAL SERVICES, L.C.
SEND PAYMENT TO : APPLIED ENVIRONMENTAL SERVICES
ALL TESTS WERE PERFORMED IN A PROFESSIONAL MANNER, AND WITHIN COMMON PRACTICES OF THE INDUSTRY.
DUE TO VARIABLES OF TIGHTNESS TESTING, THESE RESULTS CANNOT BE GUARANTEED. THERE ARE NO WARRANTIES.
EXPRESSED, WRITTEN, OR IMPLIED.
PO BOX 1073 BOUNTIFUL, UTAH 84011
.
PO#
PHONE: [phone] FAX: [phone]
STATE FUEL NETWORK
PO BOX 141152
SALT LAKE CITY, UTAH 84141-1152
UTAH DOT # 233
6601 SOUTH 3000 EAST
COTTONWOOD, UTAH
BRETT GURNEY 246107 4001397 / 1102
24047 6-11-2024
PRODUCT LINE AND LEAK DETECTOR TEST
2 @ 250.00 500.00
ANNUAL INSPECTION
50.00
DAYS TRAVEL
54 MI @ 2.00 108.00
INSTALLED AES SUPPLIED OPW 623 PV VALVE ON UNLEADED VENT
200.00
DISPENSER CALIBRATION
2 @ 75.00 150.00
1008.00TOTAL DUE: