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0 0 <br />2009 06/01 17:09 FAX <br /><m 003 <br />AFFORDA-TE$T <br />416 2n° street GaIG Ca. 95632 <br />ANNULAR <br />209 744-0112 Fax 209 7440116 <br />TANK TEST <br />Site: <br />Test Daze: <br />i;L <br />Address: 3 y H <br />City: 1—O p! Equipment: <br />Tesl Method Developed B)': Tank Manufict= <br />Other tspec Jr)r <br />/industry 1,1am9d Prof6ssimwl Engines <br />'F est Methodlimus: syutt '� <br />�!yJ� <br />Vacuum Hydt'oslatic <br />Mci uwingluluiprnentuwdtnr'I'csfing. it <br />rir-cfG H.. <br />Tank # Tank's <br />]lmk k 'yank N <br />Tank Cu acity: O <br />Tank Matenal: <br />_��• p// HCY <br />Product Stored; <br />Wait tines helw= applying <br />prcgtrr/vacuum/ water and starting <br />test:_ <br />Test Sttat Time. <br />rniaal Iteidin (!ti <br />'fest End Time: <br />Filed Rcadhr ltt <br />TCA Donation: t, r <br />Change itr R,axlin (Ittg <br />puss/Fail Threshold: <br />Test Result: <br />Was sunaor removed ter tacling? �o <br />Was seirsur proprrly replaced aacr <br />testing? <br />Comments — (include information on repaire made to testing) <br />Technician: Lyle D. Nimmo ICC #5249115 Exp. 07/01/09 <br />Signature: 1U D tp <br />Date: /.?— <br />