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WORKSMET FOR SUBMITTAL TO GOVEWlENTAL AGENCY <br /> OWNER/OP-RTARSITE ADD[ <br /> CITY ' � <br /> COUNTY <br /> "E'Y <br /> MAILING ADDRESS 7 C� <br /> SITE AGENT TELE HONE (_ ,) <br /> ARRIVED TEST SITE( 5 UPS TANX LO.CAA�TIONIM"ER +� �.s RODUCT <br /> DATE/TINE STORAGE FILLSLNeZ D 2RODUCT LEVEL AT ARRIWAL_L LUNCHES BELOW TOP OF FILL NOMINAL TANK SIZE <br /> TANK MATE RI (/ APPROX. AGF-t' YRS FILL SIZE/TY-PF �� OVERFILL CONTAINMENT TYPE <br /> API GRAYITY j�!_- T 15 DEC. F. - API GRAVITY OP�6DF ■ COEFFICIENT OF EXPANSION OF: .ODO COP OF-�c ` <br /> VISABLE VENTING APPEARS TO BE AT: FILL ENO„�FIL7 POSITS E_ , HAS BURP TUBE, UNKNOWN, HAS A BALL CHECK, OTHER <br /> VtSABLE VAPOR TRAPS TO BE BLED: BALL aIECX_S, MANIIAYS, OTHER -4� <br /> PIULSE II VAPOR RECOVERY SYSTEM TYPE: BALANCED P.4RATOR.ASSISTED LONG RUN WELLS MANIPOLDED NONE OTTIE0. <br /> PUNPINC SYSTFII: SUCTION TURBINE MAKE L C�la�1 MODEL ---. <br /> PIP@ LINE LEAK DETECTORS Y(�) <br /> CHARTED TANK SIZE �`}' @STIMATP.D LINE QUANTITY PFDDU DD@D TO FIA00 SYSTEM SYSTF.N GALLONS TOTAL f <br /> AM4IENT WEATHER CONDITIONS: TEMPERATURE PRETEST” TES UNNY RAINING CLOUDY WINDY NIGHT OTIIE ,ter <br /> SYSTEM FLOODED HOURS .4 PSI DROP&z" HOURS PSI TO HE MAINTAINED ON TANK BOTTOM INURING TEST PERIOD .-� 7 <br /> ^J/ A. CRADE TO TANK BOTTOM <br /> F B. GRADE TO TANK TOP n' <br /> C. TANK bIAVETER <br /> 7�!s! <br /> D. TFsr LEVEL Aepve GRADE <br /> • y �` g- <br /> E. EXTERNAL CROD T!R Aeove TANK ►�' _ <br /> G( F N ���/ P. TOP OF FILL TO PRo ` I <br /> DD. AT ARRIVAL r <br /> A G. TOP OF FILL TO TOP OF TANK ! <br /> �I��� H. TEST LB9EL Ta BOTTOM OF TANK <br /> RATER INS DE ca 7 PSI PER INGI OF PRODUCT ` G <br /> E TANK a - TEST HEIGHT PRESSURE FORMULA <br /> 1 / �lv x Nbf 2, 7 <br /> H. PSI B. PSI NET PSI <br /> REMARKS : <br /> IE FINAL TEST PERIOD AS SHOWN ON THE ATTACHED COMPUTER GENERATED DATA REFLECTS A <br /> o <br /> GAXN OF:i (1/,9GALLONS PERI OUR, WIT11 A 99% CONFIDENCE LEVEL OF +/- GPI1. <br /> USING THE IIORNER EZY CIIEK II MET110D OF TESTING TILE RESULTS -A : WTTTiTN <br /> NOT WITHIN TI1E STATE OF CALIFORNIA 329 GUIDELINES '5'OR <br /> GAIN OF .0S GALLONS PER HOUR FQR AK SYSTE 13E CONSIDERS TIG . <br /> INTEGRITY TANK TESTING SYSTEM, 4NC. 166 FRANK WEST CR. <br /> STOCKTON, CA 952069) 46 - 0 or (800) 262-8378 <br /> ' CERTIFIED TESTER -ST DATE6a�o-�-j <br />