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CRISP IpjG <br /> P,•0 . BOX 30487 <br /> . Stockton , California <br /> (209) 931-1828 _W <br /> i <br /> TEST REPORT <br /> OWNER OF S T <br /> ADDRESS C ti CI Y ZI - <br /> OWNEROWNERDF TTANKSTATE <br /> ADDRESS CITY <br /> STATE ZIP <br /> OPERATOR AT LOCATIO <br /> i' ADDRESS CITY �ZI <br /> -' ` <br /> STAT <br /> NAME OrCOEJIJT - — <br /> TANK tf <br /> ON OT PL AGE OF TANK <br /> DESCRIPTION TANK: <br /> CAPACITY ,DIAMETER �2 ' <br /> METAL FIBERGLASS <br /> TYPE OF SYSTEM: SUCTION: SIAMERSIBLE : OTHER <br /> VAPOR RECOVERY SYSTEM? i <br /> PRODUCT BEING TESTS / TYPE MEASURED GRAVITYr , <br /> API SPECIEIC GRAVITY R 50°F PRODUCT TEMP r <br /> STORAGE PILTEN._ DA7,�-,,�� <br /> �L�a �'cry TIME <br /> TESTED - DAT - , STARTC��i, FINISH`( <br /> LENGTH OF TEST t • <br /> MEASURED WATER 1N TANK r <br /> HEIGHT OF LIQUID LEVEL <br /> DEPTH OF GROUND WATER PSI AT TANK BOTTOM <br /> RESULTS OF TEST: <br /> CERTIFIED TIGHT? - YES_; NO . <br /> LEAK RATE PER HOUR: IF NO EXPLAIN IN REMARKS, i <br /> or <br /> REMARKS BY OPERATOR <br /> NAME OF OPERATo <br /> SIGNATURE F OPE T <br /> DATE -�- -- j <br />