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0 <br />r��®®�`��� 416 2nd Street Gait CA 95632 Spilt Bucket <br />A <br />r R. (209) 744-0112 (209) 744-0116 FAX Test Report <br />TEST DATE <br />SITE NAME � � -IR - (15 PHONE( 2.6' ) Tb-Z�- �9 17- <br />ADDRESS {oZ e,�7C CONTACT: <br />Inspector. c I PrIA Ac , La W � CQ �yy_ F Present + �j Not Present <br />3. SPJJ..L BUCKET TESTTN(;11VF01UMATION <br />TestNfethndTlscd_Hydroa nlic U Vacuum Cl Other <br />Test Equipment Used: PJL Equipment Resolution: <br />uIdcnt" <br />4 <br />Spill Bucket (By 2arek <br />Num&et•, Srored Producr, ela} <br />1 <br />2 <br />.3 <br />BuckatInstallation'I'ype: <br />DirectTiury <br />U .ontained in Sunip <br />0DirectBitry <br />U Contained ill Sun)) <br />HircLt Bury <br />0 Cowauied in Sum i <br />❑Direct Bury <br />0 Contained in Sump_ <br />�- <br />IBuckct Diameter: <br />Duckct Depth: <br />l <br />Wait time between applying <br />vsicuundwater and start of test: <br />Tcst Start Timc (Tj): <br />laitial Reading (Rt): <br />_ <br />Test End Ti me (Tr): <br />1�invI <br />f Z. 2- <br />Test Duration (Tr. Tt): <br />t <br />C"hattge in Reading (Rr- Ri)— <br />F'as9li ail Threshold or <br />Criteria: <br />P <br />_ <br />Coinments - (include infurntatinh on repairs made prior to testing, and recontmartdcd follow-up for frtil(-,d rrts'b•) <br />Test Water: Taken with tester Left on site <br />I hereby certify that all the information contained in this report is true, <br />accurate, and in full compliance with legal requirements. Technician: <br />)CC #: <br />Signature: ` `'-------__ PTTL #: <br />L00In <br />Zane A. Nimmo <br />5263322 -UT <br />04-1676 <br />YVJ TT:ZT 9002/CT/OT <br />