Laserfiche WebLink
'CRISP TANK <br /> P.O. BOX--30487T'mG <br /> • Stackton , -. California <br /> r(209)�z93i 1828 ; sF <br /> TEST REPORT <br /> h <br /> Y <br /> OWNER OF SITE <br /> ADDRESS <br /> CITYE <br /> OWNER OF TANKS r L STAT I <br /> ADDRESS r k <br /> �•. - <br /> OPERATOR AT LOCATION CITY ��] STATEZIP , ' <br /> R : <br /> ADDRESS � ,� 1 ` , `� <br /> CITY L �' ISTAIEZ&ZIpjL {' <br /> NAME OF COUNTY r !` <br /> TANK .. ON PLOT PLAN. AGE OF TANK <br /> DESCRIPTION OF TANK: <br /> CAPACITY. <br /> ,DIAMETER �� , METAL FIBERGLASS :# <br /> TYPE OF SYSTEM: SUCTION SUBMERSIBLE OTHER <br /> —"" <br /> VAPOR RECOVERY SYSTEM? • ! <br /> TYPE • <br /> PRODUCT BEING TESTED <br /> API SPECIFIC I'll 1, GRAVITY <br /> MEASGRAVITY A ;60OF` � • <br /> PISTEN: ad��CT�-T.EMP r "COE - <br /> STORAGE F1LLEN'= OATS <br /> TESTED - DATE + TIME i <br /> LENGTH OF TES START , FINISH �4) J <br /> MEASURED WATER IN TANK \J <br /> HEIGHT []F LIQUID LEVEL <br /> DEPTH OF GROUND WATER PSI AT TANK BOTTOM <br /> RESULTS,OF TEST: • <br /> CERTIFIED TIGHT? YES <br /> LEAK RATE PER HO ' NO F NO EXPLAIN IN REMARKS, . <br /> UR. + ; car a <br /> REMARKS BY OPERATOR T <br /> h. <br /> -------------- <br /> NAME OF OPERATOR <br /> SIGNATME OF OPERATOR 1 <br /> DATE ^- <br /> 1 , u 114Ni <br />