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SO# /3190 Ov- -.:r: &I.1 -',Site# �K5"77s— <br />rum-1ardarL wool <br />MONITOR WELLS <br />Well Number <br />Well Depth <br />1 <br />I3g/r <br />2 <br />3 <br />4 <br />5 <br />6 <br />7 <br />8 <br />9 <br />10 <br />11 <br />12 <br />Depth to Water <br />Product Detected <br />AMOUNT in inches <br />Standard Symbols for diagram below. OFill OV Vapor Recovery <br />/B V.R. w / Ball Float O Monitor Well O Observation Well <br />(Outside Tank Bed Area)O (Inside Tank Bed Area) <br />© Ball Float Tank Gauge Vent <br />GO <br />❑M Manway EI Iron Cross El Turbine <br />Location Diagram—Include) theVapor Recovery System. <br />. <br />-� . <br />. . . . . . . . . 5 e. S <br />rOQ. . <br />00 00 <br />wig 00 om . <br />OVrK� 8 <br />. <br />. . <br />. . . <br />1 <br />. . 00.0 . <br />. . <br />. . <br />Vapor Recovery System & Vents were tested with which tank? <br />Parts and Labor used <br />General Comments, <br />When OWNER or local regulations require immediate reports of system failure -Complete the following: <br />R1=PORTEDNAME <br />DATE <br />TIME <br />TO: <br />Phone# <br />OWNER or Regulatory Agency <br />FILE NUMBER <br />Print Certified Testers Name <br />t 0 u -),l ; r <br />Vacutectm Ce cation Number <br />Db ( i <br />Certified Testers Signature <br />Date Testing Completed <br />rum-1ardarL wool <br />