Laserfiche WebLink
Sacramento Equipment Maint lance =ompan i Inc- <br /> 2533 <br /> nc2533 Connie Drive Calif. Contr. License x502377 <br /> Sacramento, CA 95815 Wo a Js7 <br /> `91 27,6 <br /> PLEASESEPRINT Data Chart for Tank System Tightness Test Station IF <br /> 1. OWNER Property❑ y PO excX&0 S <br /> Nam Repm.lwl» brr <br /> T.ntR)ElTNap <br /> �dl��.l 1 1 CII yr/L.-r L—Eil. �-�J.CX] <br /> wm V AddreM T1.praeenWl» TNeplgna <br /> 2. OPERATOR 57 <br /> Ilam �'m TNplgr�. <br /> 3. REASON FOR <br /> TEST muf h4 perm' - <br /> (Explain Fitly) <br /> 4. WHO REQUESTED <br /> TEST AND WHEN N°""�" �,p�'�� moa ( T"" c«roaroaAffiliation Cot. <br /> Addrm T.bpwrw <br /> IdeMiy by OMWIon Capacity _ lymd/Suppller (Irad. Approx.Age SrIIN?IbrplaM <br /> 5. TANK INVOLVED <br /> <QttS <br /> lV"aadditionalYnat © <br /> for manllolded broke S <br /> Locution Cc»r Filo Vanb &pgrw Pumps <br /> 6. INSTALLATION <br /> DATA L/ 2 <br /> S QVC. Yl/G1 <br /> Nord In.id.drhway. Concm Bock Top Sha.Tbllll maks.drop SuU' R.ngla. <br /> RNI M p.hon,NG E orbs.R.mot.File shit,Menlloklw which isms? Wk. <br /> 7. UNDERGROUND YwrMerer tiWkf <br /> WATER D.pd to she wMM table ❑Y» ®Ib <br /> 8. FILL-UP T.M bbmw hr. ata A Wvwy Nan" T..pw» <br /> ARRANGEMENTS v Extra product b lop off aw un lank Inter. Ilow aw Who"pwAd.T Corokar NO Law <br /> Twmibl w parr cenlad <br /> for notlb w kprwy <br /> Company Noma TNaptwr" <br /> 9. CONTRACTOR, <br /> MECHANICS, <br /> any other Contractor <br /> let»I»d <br /> 10. OTHER <br /> INFORMATION <br /> OR REMARKS <br /> Addhbnal YdprmNbn on any Marra above OMpale or Mbn to b adhw rhn".tiro Y In proems or compMw.wseon w abp»n prwa d q wvL Mc. <br /> Tests were made on the above tank systema In accordance with test procedures prescribed for <br /> 11. TEST RESULTS as detailed on attached test charts with results as follows: <br /> Tmk Mentlacallon Tight Wkapa kWulod Op.Tmed <br /> :Gz4n1f 7 – /-7- <br /> -7 _ <br /> 12. SE46W I 1 J 7 7. 13.This Is to certify that these tank systems were tested on the delete)shown.Those indicated as"Tight"meet the criteria established by <br /> CERTIFICATION the National Fire Protection Association Pamphlet 329. <br /> Terns It is the responsibility of the Owner andyw Operator M this system to immwialely advse nate and kcal authoraiss of ary <br /> FN V Ir)CINMP UL HE 17:1 Implied board and the possibility of any reportable pollution to the environme s n a result of the a dicalw failure of this <br /> MMIT/SERVIC1' tsymn.Heath CanwllanblrcaporpwandlorSACRAMENTO EOUIPMENTMAINTENANCE COMPANY,INC.does W <br /> aarb Mo.of T ermal assume any responsibility w lability ora for any kof product to the environment <br /> C.rtlfloatlon a . <br /> Barleor <br /> ,l, <br /> CeNanMon F Tank Owner/Operator ! Date <br /> 101 <br />