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CRISP TANK TESTING <br /> 2004 Piccoli Rd. #9 ADDRESS <br /> t <br /> Stockton, CA 95205 ASY TESTING METHOD <br /> 330 So , t1r,; <br /> MAR 1 5 i `. :� WORK SHEET CITY-STATE-ZIP CODE <br /> bS-'-31 CUItoI ENVIROMENTAL HLALTH I �, �J�3i•U <br /> FERMIT/SEHVICES OWNER OFTANKS <br /> TANK No. n TEST LEVEL �/ q —PRODUCT//,p (e to PJ- CAPACITY;)o—') CHART CAL 05 – 3 3 .,00/ S I JAI <br /> 91, <br /> ADDRESS <br /> MEASURED GRAVITY 7r PRODUCTTEMP COEFFICIENT b TEMP CALOOO60Q.29 (B) <br /> Air Temp <br /> TEST LEVEL LEVEL GAIN+ x(A) LEVEL TEMP. TEMP. GAIN+ x(9) TEMP. FINAL CITY-STATE-ZIP CODE <br /> NO. START END LOSS— x(A) RESULT START END LOSS— x(9) RESULT RESULT TIME <br /> _ = x • — _ = X OPERATORS NAME AT SITE <br /> t X s 7 s X / . c 7 / <br /> '0 0 J n r / �-- • �� f � � CJ D J 6 J .o o 3 6 � TYPE OF SYSTEM <br /> .-' ❑SUBMERGE ,SUCTION <br /> X — ` X / <br /> j ? ! / _ .� !, _ , Q ) LENGTH OF COLOR CODE OF PRGD'J: <br /> '0 O O T C�j / • V 7 �l FILL PIPE CLEAR ORANG <br /> RED <br /> r� X — r (� X DIAMETER OF TANK <br /> V "rJ rl �� f_i ��✓ 'T� .� r .� (I J 6 0 --t3' METAL <br /> S ❑ FISERGLA <br /> G ^ — xO ! ( / p D r/� • f= v �� �� • U b�� r� TYPE OF RECOVERY SYSTEM• / P [)BALANCE ❑ RED JACKET ❑HEAL! <br /> �c X • — <br /> '� >) /%: �_ WATER LEVEL IN TANK Liquid level <br /> i <br /> 67 001 I . � T � J. ��}:� j • `1V� --,,. • '1 }'J ��.j�4> <br /> DEPTH OF GROUNDWATER (IF KNOWN) <br /> DATE/TIME STORAGE SYSTEM FILLED <br /> DATE TIME <br /> STATION LOCATION �,� P i1� `' �� CERTIFIED TIGHT / 4 <br /> AGE OF TANKS <br /> ADDRESS LEAK RATE PER HOUR C� <br /> CITY a �, STATE 111-114 OPERATOR L- eJ I� � ! y AQE-OF LINES <br /> DATE -�—' '� (' SIGNATURE'�n��"c/li,�J� <br /> TESTING FLUID,IF DIFFERENT THAN <br /> llVLq Ft1C CCtVAGVc STOREDMATERIAL M� <br />