Laserfiche WebLink
•Data Chart for Tank System Tightness Test <br /> PLEASE 1 F 2 ! 1988 <br /> ENIMMENNie IkA 6(y)( Addres° Representative Telephone <br /> "°m° <br /> PERMIT/SER 1lMES <br /> Wine <br /> Addre Represent ive Telephone <br /> 2. OPERATOR for <br /> Telephone <br /> Name <br /> 3. REASON FOR <br /> TEST <br /> (Explain Fully) <br /> 4. WHO REQUESTED Name Title u,�Compeny or AL fliliu bn Date <br /> TEST AND WHEN <br /> Address Telephone <br /> Identify by Direction CaPecity Brend/Suppller Gred Approx.Age St IMPerglass _ <br /> 5. TANK INVOLVEDQ� <br /> Use additional linea <br /> for mani+olded tanks <br /> anon /1 Cover Fills Vent, Siphhones EG <br /> 6. DATA ELATION // //^ �,/ Q// !�C ote, <br /> North inside driveway, Concrete.Black Top. Size,Tlteilmake,DopReer of station,etc. Earth,ata tubes.Remp[e Fills Sze.Menlloltled VfiicM1 tanks? wn <br /> Is the water Ju oveIr�thIe tank? <br /> an <br /> 7. UNDERGROUND CyNo <br /> WATER Depth to the water table <br /> Tanks to be filled hr. Date Arranged by Na,ne Telephone <br /> 8. FILL-UP <br /> ARRANGEMENTS Extra product to-lop o+1'and run tank teeter. Now and who to provide? Consider NO Lead. <br /> Terminal or other contact <br /> for notice or mculry Company Nape Telephone <br /> 9. CONTRACTOR, <br /> MECHANICS, <br /> any other contractor <br /> Involve! <br /> 10. OTHER <br /> INFORMATION <br /> OR REMARKS <br /> Additional information on any Items above.O+iiciala or others to be advised when testing Is In progress or completed Visitors or observer presets during feet,etc. <br /> Testa were made on the above tank systema In accordance with teat procedures prescribed for <br /> 11. TEST RESULTS as detailed on attached teat charts with r its es fellows: <br /> LeakageIndicated Date Tested <br /> Tank Identification Tight <br /> 12. SENSOR 13.This Is to certify that these tank systema were te772 <br /> Thoes YlAeated as'Tight"meet the criteria established by the <br /> CERTIFICATION National Fire Protection latlon Pamphlet 3anng Conal r or Company. By: Signature <br /> MEN <br /> Serial No.o mermal Certification« a TRIANGLE INC. OF SACRA <br /> Sensor <br /> X 9795 AddfeB° <br /> 2 SACRAMENTO, CALIFORNIA 95823 <br /> PN6827 <br /> Certiilcatlon a <br />