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SO# Ownq6 Ul57— 0 Site# <br /> MONITOR 'WELLS <br /> Well Number 1 2 3 4 1 5 6 7 8 9 10 11 12 <br /> Well Depth <br /> Depth to Water <br /> Product Detected <br /> AMOUNT in inches <br /> Standard Symbols for diagram below: T)Fill O Vapor Recovery <br /> />3 V.R. w / Ball Float Monitor Well Q Observation Well <br /> (Outside Tank Sed Area) (Inside Tank Bed Area) <br /> Ball Float @ Tank Gauge 0 Vent <br /> 0 Manway Iron Cross L'� Turbine <br /> L CatIQ�.. j am-include the.Vpor Recovery System.. <br /> . 6oefa�V/ ' . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . <br /> 5,,/)tVA.) L.A11�. <br /> . . . . . . . . . . . . <br /> �nJ'"'a r s-f 4 <br /> apor Recovery System & Vents were tested with which tank? <br /> Parts and Labor used <br /> General Comments <br /> .5 'C1,2 14 ie.� c,_/"s <br /> When OWNER or local regulations require immediate reports of system failure-Complete the following: <br /> REPORTED NAME DATE TIME <br /> TO: , r r � - /- c <br /> Phone# OWNER or Regulatory Agency FILE NUMBER <br /> Print C014ed Testers Name Vacutec"Certification Number <br /> Certified Testers Signature Date Testing Completed <br /> Fwm-r.NW1Jr*;9 <br />