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so# owner: <br />Sate# <br />MONI R WELLS <br />Well Number t 2 <br />3 4 5 B 7 8 <br />9 10 11 1 <br />Well Depth <br />Depth to Water <br />Product Detected <br />AMOUNT in inches <br />.Standard Symbols for diagram below. L1Fill <br />CNJ or Recovery <br />/g VA. w / Ball Float <br />l"1 Monitor Well <br />QObservation Well <br />@ Ball Float <br />(Outside Tank Bed Areal <br />@ Tank Gauge <br />(In aide Tank Bed Area) <br />Vent <br />L'"`I Manway <br />L '_i Iron Cross <br />Turbine <br />LOCation Diagram—In <br />Iude the Vapor Recovery S stem. <br />Q <br />0 <br />—1 4 C L . u_ . . <br />. . . . . . . . <br />Svcs ZrvLQ } P_vry <br />Vapor Recovery System & Vents were tested with which tank? C '' Cl u6 f�L`✓ D <br />Parts and Labor used <br />General Comments <br />When OWNER or local regulations require immediate reports of system failure -Complete the following: <br />REPORTEd HAVE DATE TIME <br />TO: <br />Phone# OWNER or Regulatory Age FII..E NUMBER <br />Pn Test6r NVacutecfrm Certification Number <br />l 1 �tv <br />Ce a rs Signature Date Testing Completed <br />'r <br />