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Ave <br /> WORKSHEET FOR SUBMITTAL TO"GOVERNMENTAL AGENCY <br /> OVNER/OPERATOR �(�� �ISr,• �pK.(/ SITE ADDRESS <br /> CITY <br /> couNTr_ <br /> MAI LLMC ADDDIISS_ <br /> SITEAGENT <br /> TELEPHONE �) <br /> b'/Yy(� S`O✓ �2��� <br /> ��..yy��jj - -•'��� <br /> ARRIVED TEST SiTT� Ia4TTAD ��� � <br /> t }RODOC7 Q� <br /> DATE/TIME STORACE FILLED It z PJKDDOCT•�`ET ATAluNITAL11—MMES BELOW�TOP OF IILL NOMINAL TANK SIZ <br /> hR <br /> TAMATERIA_, e.�. APPRDI. TANK AGR�/�TKS. FILLSIZE/TYPE 4 <br /> API GRAVITY 6Z S'7 OVERFILL CONTAINILENTpI�TPEjty,_� <br /> A7 DEC. F. Qi @AI;7T 0T1i'�T ! 60F COEFTICIENT OF MANSION OF .000 701<0 e Coe 46 97 <br /> VISABLE VENTING Ap}RUILS TO BE AT, FILL Elm OPpSTTE END RAS DURP T11B <br /> HAS DOLL CHECK, UNKNOWN, OTHER <br /> VISAHLE VALOR '[LAPS TO LL BLED: <br /> CBS . XANStA7S. RETURN LINES, OTHER <br /> PRASE II VAPOR RECOVER? STS77f: ASPIRATCR ASSISTED, LONG RUN WELLS, MANIIOLDED, NONE, OTHER <br /> PUHPING STSTTII. CQ N TURBINE NAKIE MODEL D-'7 OV <br /> / PIPE LINE LEAR Detectors TES, NO; i APPLIC <br /> CHARTED SIZE `� EST. LIRE!6,OMV�ARTITT�Z PRODUCT ADDED TO FLOOD Sysm 1� STSTEH TONAL GALLONAGE <br /> AMBIENT CONDl7I0Mi! 77W, PIlE7LHT YP'POSTLST PAMf0T.0UD RAINING, WINDY, BREEIT, NICHT. OTHER _ <br /> •6 PSI DR04k4lo L5 TEST TO S!A �.�J <br /> LT FSI TO EL MAINTAINED ON TANK BOTTOM DURING TEST PERIOD PSI <br /> R. GRACE TO TANK larITH /A38' f <br /> O E. LNADH TO TANK TOP 4.4 <br /> 6 upE C. TANK 01AYSTER 9' <br /> D. TEST LEVEL ARM CUM -77- <br /> 1. <br /> Z.E. tKTEKNAL CROU10 NATER A20VI TANK <br /> G F� __ }/ BOITP1 l". K .0361 rs7 <br /> r. Top or FnL TC PROD. AT ARRIVAL 1p <br /> 8 G. TOP Of FILL TO TOP Of TANK 3p <br /> H. TLTT:.I2m-TQIOrta Or TANKQ�' <br /> WATER 1 IQ PSI PER INCH OF PFDV .7 <br /> TARK . <br /> E TEST MEMim pt"SURI popayu �J c <br /> S s 4. 43 <br /> REMARKS: =7 6 psi j. rif MET PSI <br /> RESULTS <br /> ��THE FINAL TEST PERIOD AS SHOWN ON THE ATTACHED CORPUTER GENERATED DATA REFLECTS A <br /> k�„0/`fibP / GAIN OFil-iDA GALLONS PER HOUR, WITH A 9912 CONFIDENCE LEVEL OF +/- •�OOa gph <br /> THE EOHLER ELY CSED II 0 COMPLIES PITH DFA ADD SSL STATS OF CAAI�,,T70EDIA PHBIODMAHCS STANDARD 0} 4.Oy OFS <br /> FOR ?ARK 1ST INC. ISHCTAOH E64E CALIFORNIA CODS OI' RDOOLAYIODt) BASED OROS THIS ANDARD 0 T0. RESULT <br /> SNOWY ABOVII, DS HO IDDICATR AT UDAUTIORIEtD REL{ASN ;QU <br /> . .y� 4H13I6• ` <br /> OEaft FKID TSDTSH STATS LICDDSD <br />