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L'ulil l.tluft IOf Ii,I1lC 5yS1( I11 Ifgit'tf1CSS IBSt��/G/ n <br /> petro Tile ' <br /> PLEASE PRINT U57K 1ESTER <br /> 1. OWNER Prpl»nr © TIqArhpvrnnTnr (41 9) 818_ <br /> M5109 <br /> .wN MOrOa MMwnto 1WpnW <br /> T.nkte) ® Attn: Bob Stolz <br /> No. A ldrw a.p...n.0. 1N.MeM <br /> 2. OPERATOR i/I✓a /i/AJ f�CY� 515- -e Z'.) CA. (�i ^. L• I/3C <br /> Nam. AdOr.Y 1N.M.M <br /> 3. REASON FOR qho� R411 <br /> TEST <br /> (Explain Fully) _ <br /> 4. WHO REOUESTED Bob Stolz Engineer Chevron USA Inc. 5-11-87 <br /> TEST AND WHEN N.m. Tlw Corrrp.n,e.Meebn <br /> 2 Annabel Lane, Suite <br /> Add,... TN.pn.rw <br /> 5. WHO IS PAYING Cpm arra Ap.nc or lnavWwl Peron AahorBMp Two Tel.phone <br /> FOR THIS TESTI <br /> Bdlinp"Mau Ury CYN ztp <br /> Munlion nt: Wd.l No. 01h.,IruuwupM <br /> Identify by Dkaction Capacity Brand/SNPpliw Grade <br /> Appoa-Age iWrplaas <br /> 6. TANK(S) INVOLVED T 2 .3 /0006fiE C ��,� dJ9 �o:� ¢ K'Z <br /> Location Cover Fills Vents Siplronas Pumps <br /> 7. INSTALLATION C;wgr-Tr c3 ' Ficl <br /> DATA �//? <br /> See Map n�fd oZ• .Cc.s/c,7' <br /> North WIa.dd..war• CeecrNe,Black Top. Clsk Ta.Bq wak.,Dlep Su<rbn.a.n.ele <br /> Pui Ol.uuon,arc 4M..1[. [ub.a,A.—Ol.M. sure.M.nHou," which lanU/ Mat.11 I.... <br /> 6. UNDERGROUND ) �- Is care watw Link itank? <br /> WATER Depth to the water"we ^ n�C OLr SEu <br /> 13 yes 4 No <br /> Tato b filled 8:00 Id. /0/2--7/2 Date Manp.d by AB Precision Env;ronmPntal (415)5Q9-1R <br /> 9. FILL-UP wen. 1N.pn.ne <br /> ARRANGEMENTS Eats Product to-lop air and tun TSTT. Now and who u provide t Consider NO laked. <br /> Terminal w other rbntacl N/A <br /> 1«eotica w inquiry <br /> lsmwnY <br /> We. 1,0.0hone <br /> 10- CONTRACTOR <br /> MECHANICS, <br /> any otter contractor <br /> unvi.d <br /> 11. OTHER :SPcAsr -77v i::s .rte . Z-41721fir J,a rlZ t , <br /> INFORMATION 7Z1XVL -iZ 7r Al)_ 73 <br /> OR REMARKS <br /> Additional infomution on any items above.011w"w other to be advised when lading is in propre"w completed.Visitors a cbservt a pr.aant <br /> during test etc <br /> Teats were mate vel ttu above Wk systems to accordance with test procadune prescrlbd for pr}r2 7� <br /> 1L TEST RESULTS es deWNd rxt attached lest Churls with results as tituaws: Xvu <br /> Tank Iden['' lj Leakage Indicated Data Tasted <br /> This Is to carry that sew tank systema were tested But the date(s)shear Those huilcalad w-nghr" t ne vLLw established b( <br /> 13. CERTIFICATION the wumd Fin Prwactlon ASQCULIp Pamphlet 328. <br /> 6-18-87 Mark Morrissey AB PRECISION ENVIRONMENTAL <br /> 17191081 <br /> 1„anp Gan..[Or w Cemp.n,. -B,: Cq rwn <br /> Tt3 ; 1081 Alameda De Las Pulgas #85 Belmont, CA 94001. <br /> bone No.a Termak 1.[Ar.crr� <br /> Ada a. <br /> S. <br />