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Feb 13 09 08: 18a Elite Contractors Inc 20946 12 P • 3 <br /> Pale of �. <br /> sw1kcB,January?ua^- Rc ort Form <br /> Secondary Containment TestinOg, P <br /> This.%nrnr is An,:ndrel,%nr uct•!ry cmurerCror•,r per,,/in•min�r periodic 2wli11R QI CiST.ree•undury conlnintnerrl,vvslems. Ci <br /> Uxe 1ht• <br /> nrnr to repurl rra',Illrrnvi 111 ut dna l njts ililc ownar I rprrcaurl n'subodllnl/otlh«`/v rlrrr�nl rinnrnrncnc <br /> npprnprfale pa}eN uJ'rhis,/' <br /> prinluuls lirun <br /> WON(il oppllCoh/cq,should hep' 779 <br /> 1. IIACII..1'PY INFURb1AI'IONDal74of'1'csling:ilily Numc: 1�' rL�r�Fucilil AdilresN: Phone:yossa Chi—PacilitOlac_ <br /> Dale Local t**:",cnt:y Was Notitictl ul'Ibvling[ -� Ti)� — <br /> Nama of Local ,1 tcncy Inspector(i/'pre..cul chrrirrg MYlbtg) <br /> 1. 'f F.STING CON'hI2AC'I'OR INFORMA'l'lON _ — <br /> ( '�d�ETIC, <br /> any Name�:icamC' Irdodtmp_I'C- ,.— — '— _ ---- <br /> _ SbVRCO[.iccnst,•dTank'I'cstcr <br /> Craknuals: C'SLB Lic nscd ContractorLicense NLIn1LtCr: <br /> 00 <br /> Licensc'I'ypc: — <br /> Man nfact urer Trainion Dow Tralnin r Eris <br /> _ M�anuVT <br /> �l;icturcr , ——. -- -- <br /> 3. SUMMARY OP'rEST RESULTS Not ltcparrs <br /> Not Repair. Component Pass Rail •1'cNled Made <br /> CwnPm,c„t Pass Pail 'I'cshd Matte _—.— <br /> i, — <br /> I <br /> -- <br /> I <br /> -I LI I_ Ll <br /> c <br /> I J n <br /> I II <br /> _I <br /> U <br /> — <br /> fl <br /> (('hydrostatic lestinit was Performed•descrihe what was done with the water atter compl0i0n oPlcsts; _ <br /> CERTIFICATION OF TECIINICIAN RESPONSIBLE FOR CONDUCI'ING1'1118 TESTING <br /> To the best efug knowlei4ko”the facts scaled in this doctnnenr are.,accurate and in fill Compliance wi!!t legal rerlairenrenIN <br /> Technician's Signatare:r � Dole: <br />