Laserfiche WebLink
CRISP TANK TESTING <br /> 2004 Piccoli #9 a ' 7" <br /> (209)931-1828 ° + <br /> Stockton, Ca 95205 NOV 2 9 1989 <br /> TEST REPORT ENVIRONMENTAL HEALTH <br /> PERMIT/SERV;CES <br /> UWNER OF SITE ) _ <br /> ADDRESS )i /l i'l l (i' . , CITY < 16 STATE IWj'�%�/ �. <br /> OWNER OF TANKS ) . <br /> ADDRESS_ L a== CITY ! y' STATEZILZIFr ". 12. <br /> OPERATOR AT LOCATION <br /> ADDRESS /�,' 1:'. (' STATE% ZIfy <br /> �;',�.' CITY <br /> NAME OF COUNTY—' y i j f J­( j, !Mf <br /> TANK # ON PLOT PLAN. <br /> DESCRIPTION OF TANK: <br /> CAPACITY L ' L DIAMETER / .' METAL /\ FIBERGLASS ,AGE <br /> TYPE OF SYSTEM: SUCTION SUBMERSIBLE ETHER <br /> VAPOR RECOVERY SYSTEM? ; TYPE <br /> PRODUCT BEING TESTED • i:, MEASURED GRAVITY ? ,� <br /> COEFFICIENT ' ,! TEMPERA URE OF PRODUCT_J , AIR <br /> STORAGE S5YySTEM: <br /> FILL - DATE �ctil. ?i ) I �> TIME !LL(i / Ig <br /> TESTED - DATE i , :?,'j �;, START ( „ FINISH t' , <br /> LENGTH OF TEST <br /> MEASURED WATER IN TANK HEIGHT OF LIQUID LEVEL _ <br /> DEPTH OF GROUND WATER F y. PSI AT TANK BOTTOM ), ` <br /> RESULTS OF TEST: <br /> CERTIFIED TIGHT? - YES ; NO�. IF NO EXPLAIN IN REMARKS. <br /> LEAK RATE PER HOUR: + ; or - % .;(�(�� s,n. <br /> .REMARKS BY OPERATOR f aA'4 yl h fa i' S /c� �1 3 v( a ) y Ise o c � t .7 <br /> NAME OF OPERATOR <br /> SIGNATURE OF OPERATOR <br /> DATE <br /> d fl1 C <br />