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A KNOLOG <br />,w{ ... _�� ___ , VacuTect'ni TEST REPORT <br />TECHNOLOGY FOR TANKS 0 <br />AND THEIR ENYIRONNENT N F A ii f <br />i4� <br />Owner Site # 9577 <br />Invoice Name/Address _0f+Ev,Pon/z Elm. 111-?a.� <br />Site Name/Address (�, VeCA-J 1361 Low✓/ ,A 95ZAb <br />S.O. # i/ 7z 5 y <br />Date -IZ--7 <br />Phone �S/ol B�Jz - Z Y/ <br />Attn: <br />TANKNOLOGY Region: Unit # -/Z State Lic. # /578 State: <br />NOTE: Original VacuTect Data recordings are reviewed by Tanknology's Audit Control Department and maintained on file. <br />TAK-02 <br />Tanknology Corporation International <br />5225 Hollister St., Houston, TX 77040 <br />(800) 888-8563 • FAX (713) 690-2255 <br />TANKS <br />LINES <br />Leak Det <br />See <br />Ullage <br />TANKS and LINES Tested to CFR -40 Parts <br />Diag <br />Tank <br />Dipped <br />Dipped <br />Probe <br />Water <br />Bubble <br />Air <br />Line <br />Final <br />Exist <br />280-281 & NFPA 329 Specs. <br />For <br />Dia. & <br />Water <br />Product <br />Water <br />Ingress <br />Ingress <br />Ingress <br />TANK <br />Line <br />Delivery <br />LINE <br />LINE <br />Leak <br />LINE <br />LD(s) <br />NEW <br />Loc <br />Material <br />Level <br />Level <br />Level <br />Detected <br />Detected <br />Detected <br />■ <br />Material <br />Syst. Type <br />TEST <br />TEST <br />Rate <br />■ <br />Pass/ <br />LD(s) <br />ST/ <br />■ <br />■ <br />■ <br />■ <br />■ <br />■ <br />Tight <br />■ <br />■ <br />■ <br />■ <br />■ <br />Tight <br />Fail/ <br />Tested <br />Tank <br />Tank <br />Tank <br />FRP/ <br />START <br />START <br />START <br />or <br />ST/ <br />START <br />END <br />or <br />or <br />& <br />Other: <br /># <br />Product <br />Capacity <br />Lined <br />END <br />END <br />END <br />Yes/No <br />Yes/No <br />Yes/No <br />Fail <br />Line tt <br />FRP <br />PS/SS/GS <br />TIME <br />TIME <br />GPH <br />Fail <br />NONE <br />PASS <br />W/o <br />Diameter/7 <br />ameter_ <br />/ 7 <br />1 / <br />, • <br />N <br />G/rVL� <br />I <br />_ <br />/ <br />� <br />Ea�sl LD -14SN/MDL/MFG'. � <br />/7 <br />• / <br />I <br />/ <br />0 <br />7ALINE <br />New LD SN/MDL/MFG <br />104at <br />Material <br />Start Time: <br />15, 3L� <br />rCent O <br />Time of Test:1(4 <br />Z� p <br />M;mp <br />�` <br />TEST PSI f <br />fxn <br />D,oeneShear Vale.3S N <br />n Probe nc I <br />T �;// <br />Tim <br />I:o <br />,L <br />O rater esno .4 <br />S <br />Diameter <br />�AN <br />_ <br />� <br />� <br />- �sl.s. <br />�j <br />6p .'•3Z <br />9-'10 2- <br />-1ea• <br />?- <br />N <br />E:iSI LD SN/MDL/MFG: /�� <br />/ <br />New LO SN/MDL/MFG. N1 <br />Z 8 �J -s, Z1 - /(P •7/ , yGj v- % <br />/V <br />s /, <br />LINE TEST PSI 15 - <br />alerla <br />Percent O : at Pump c� C C� Z :Z t 0 0 "� <br />Stag Time: Time of Test: Mfg.: 0a JT cl .J ZZ ✓V -rtT'• <br />End Tim : <br />tank <br />an <br />Test PSI: <br />Probe <br />Ent <br />Inclinometer <br />Decrees <br />Dispenser Shear vales . /vN� <br />o erase i es/not <br />Al <br />Diameter <br />O <br />-d <br />3cAS7-�s <br />/q-tos <br />19�3s <br />—b{r- <br />E.W LD SN/MDL/MFG'VIA <br />D SN/MDL/MFGO n(/ <br />J / 0.3, 7Z:33 Z j '03 <br />/7 <br />LINE TEST PSI /S <br />tena <br />Start Time: <br />Percent o at <br />Time Of Test: <br />Pump <br />Mfg.: <br />Dispenser Shear Valves Ny <br />rno Operate I es/wa O <br />lank Probe Inclinometer <br />End Time: T PSI, n <br />lameter <br />'AA/ . <br />% �¢` <br />/ <br />C� <br />`� r 2/_ <br />GO r <br />�- <br />7"' <br />-/ <br />/IrA <br />Exist LD SN/MDL/MFG W14 <br />/ <br />V �' <br />20 _`./SCO <br />20) <br />T <br />H <br />New LD SN/MDL/MFG: /q/a <br />Material <br />Start Time: <br />cent o I at <br />Time of Test: <br />Pump <br />Mfg.: <br />0 <br />o <br />cl7- <br />o <br />J •S. <br />7 3 `O <br />2- 3 1 3S <br />% <br />N <br />LINE TEST PSI / 5 <br />Oseratepenelres/noShe.rlValves AIW4 <br />lanEnd Tim : : es roe ne Inometer `� 5'.s Z.3-,3 -'�8 -�,_ T <br />T I:Entry <br />lameter <br />Exist LD SN/MOL/MFG. <br />-. <br />- <br />New LD SN/MDL/MFG: <br />LINE TEST PSL <br />Material <br />Start Time: <br />rcenl oi at <br />Time of Test: <br />Pump <br />Mfg.: <br />_an <br />Dispenser Shea, Valves <br />O e,ate estnol <br />Probe Inclinometer <br />End Time: T I: - n D r <br />lameter <br />- <br />E—I LO SN/MDL/MFG: <br />- <br />- <br />New LD SN/MDL/MFG <br />LINE TEST PSL <br />Material <br />rcent of F I I at ump - - <br />LStart Time: Time of Test: Mfg.: <br />Time: <br />tank <br />n PSI: <br />n e <br />Dnc urometer <br />Dispenser Shear Valves - <br />O erase es/no <br />TANKNOLOGY Region: Unit # -/Z State Lic. # /578 State: <br />NOTE: Original VacuTect Data recordings are reviewed by Tanknology's Audit Control Department and maintained on file. <br />TAK-02 <br />Tanknology Corporation International <br />5225 Hollister St., Houston, TX 77040 <br />(800) 888-8563 • FAX (713) 690-2255 <br />