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Crisp Tank Testing & Construction Company <br /> Phone (209) 931A828 <br /> Post Ottice Box 30487 Licensed <br /> Stocldon, California 95213 Insured <br /> LICENSE #92-1248 <br /> *TEST REPORT* LEONA7D E. CRISP <br /> r DATE: EC. o2G /RAJ/) <br /> OWNER OF SITE: C QI1If iTlYllf� l 7 -" <br /> ADDRESS: 4�D ] F l��at��l CITY : <br /> OWNER OF TANK(S).' �p�i� Lanue hlf) i <br /> ADDRESS: 4�I�-] F, �a � d <br /> We <br /> te`=��"-- <br /> OPERATOR AT LOCATION:_ 1G�lir' jn n( <br /> /Tfn�Pn � j�PF <br /> ADDRESS: �IO-I �Al/�L�.P /n71 &QCITY : L <br /> . ZIP: <br /> NAME OF COUNTY: nay r) �!-TOCA y AGE OF TANK: <br /> TANK#: CAPACITY:_10 /»n GALLONS . METAL:_ FIBERGLASS: <br /> SINGLE WALLED: DOUBLE WALLED:_ DIESEL: PREM. UNLEADEDeX <br /> UNLEADED: REGULAR LEADED: KEROSENE : WASTE OIL: AVGAS: <br /> VAPOR RECOVERY--YES-NO IF YES, PHASE 1 : �/' PHASE 2 : >( , <br /> SYSTEM TYPE--SUCTION: SUBMERSIBLE <br /> INLINE LEAK DETECTOR--YES N0� <br /> SHEAR VALVE--YES_,X_Np OVERSPILL CONTAINER--YES NO:. <br /> -_TANK FILLED--DATE: TIME: <br /> TANK TESTED--DATE: <br /> ^��7" .START: 0 10 FINISH: n 6)04 <br /> LEGNTH OF TEST:_ �Z HOURS . _MINS. <br /> TANK BOTTOM TO GRADE:: TANK TOP TO GRADE: <br /> it . DIAMETER: <br /> TEST LEVEL ABOVE GRADE:: WATER IN TANK : , <br /> „ <br /> DEPTH FOR TAKING SAMPLE-/4� _ TEMPERATURE PROBE DEPTH:: , <br /> „ <br /> TEST LEVEL TO TANK BOTTOM::Z <br /> " GROUND WATER ABOVE TANK:_: , <br /> PSI :JQL. NET TEST PRESSURE: <br /> **RESULTS OF TEST** <br /> CERTIFIED TIGHT--YES_X NO <br /> LEAK, RATE PER HOUR: + _ o3 Q <br /> SIGNATURE OF TESTER- <br />