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c���� s�� � 416 2nd street Galt CA 95632 � PUI Bucket <br /> (209) 744 0112- (209) 744.-0116 FAX <br /> Test Report <br /> TEST DATE <br /> SITE NAME ,cy 4 cr�v PHONE <br /> ADDRESS rZpo27 -._[•'✓+� y CONTACT; /r <br /> Inspector: V,Al Not present <br /> I SPILL BUCKET.TESTING.MFORMATION <br /> Test Method Used: �i -dsostatic D Vacutina ❑Qther <br /> Tc't Equipment.Used., ��� � Egnipment Resolution: <br /> Jdontify:SpllTBtglcet.(By Tank' <br /> ;Number, Stored Product, etc.J <br /> Q <br /> I3uckct 7nstallatiori e: 0 nirect Bury d Direct fury C Diredt B <br /> Col2tained in S - '' .' D Dircct Btuy <br /> ntkizied in 8zuri Contained i]l u _ ❑Contained S <br /> Bucket Iliometer: <br /> Bucket Deptb.: r y. <br /> Wait time bGtv�Yeen applyring <br /> vacnumlwater and start bf tcst: <br /> Test Stsst.T'irne(TO: O, <br /> Initial Reading(Rt). /2 <br /> Test B-ad Timc(TF): G1 JU - <br /> Final Reading(RF): %Z— <br /> 1 t <br /> Tcst Duration(TF—Taj: <br /> Change in Reading(RP-R); - <br /> Pass/Fail ThrcibDld or <br /> Critezia: y <br /> .1 <br /> .Comments.'. include information on re a sbnade riar to t ting, and recommended folloyv-u for faired testsJ. <br /> Test Water: LETaken with tester E]Let on site <br /> I hereby certify that all tj e information contained in this report is true, <br /> "accurate, and in full compliance with legal requirements. Technician;, carie A. Nimma <br /> Icc : 5263322-UT <br /> Signature OTTL#l: 04-1676 <br /> 500 .d 80 j 0858602 i �� xu .HM SSH7 ao� aoN kv H :90 anIlgeouzzliflf <br />