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CRISP7'ANl{ 'I,_7'ING { OSS He OCL <br /> 2004 f iccoH #9 Undcrground StoropcTank <br /> Stockton, CA 95'105 RORNCR SYSTEM <br /> (209)931-1828 <br /> OWNIER OF SIIENocdrs,b TA//o« C., <br /> ADDRESS_g3.7 C2o<:+sLy D. c /<,J. CITYlllod,sS /o STATE,-/; ZIP 95352 <br /> OWNER OF TANKMoDEsro 7:,//ow C. . <br /> ADDRESS y3SC.eoc,s CITYIt/&4', 7�, STATES IP 953522 <br /> OPERATOR AT LOCATIOhJ_�'ACrFOR� R SfRA�/ .D4Z ►U/r�� ll��l <br /> ADDRESS '/2z) E. /HARrycsA �c/ CI TYS'�ocic�o✓ STAlEZIP f,5-2(,ijt-� <br /> t; <br /> NAM= OF COUNTY Sq,U JoAOv, J <br /> TANK # ON PLOT PLAN. ENVIkUryt,,,lAL NcALTH <br /> DESCRIPTION OF TANK: CAPACITY ,j`/O G.at. ,DIAMETER_y FERMIT/SERVICES <br /> , AGE /4� Yi1S. <br /> METAL__; FIEERGL.-A,SS ^GC Of LINES_14YirS <br /> STORAGE SYSTEM: TYPE- SUCTION ,r SUBIAERSI6LE , OTHER <br /> FILLED - DATE 2 TIME <br /> TESTED - DATE 7-ism , START 3o FINISH /,30 <br /> LENGTH OF TEST _�2 yap ey <br /> VAPOR RECOVERY SYSTEM; TYPE <br /> PRODUCT BEING TESTED /�rPseC MEASURED/GRAVITY,334 <br /> COEFFICIENT 33. / TEFJPERATURES: PRODUCT A ? ' , AIR <br /> WATER IN TANK C DEPTH OF' TANK TOP FROM GROUND LEVELq 7 <br /> GROUND WATER 3e10w .20 � LIQUID LEVEL IN STANDPIPE /30 <br /> TEST RESUL15: <br /> CERTIFIED TIGHT? - YES X ; NO <br /> IF NO, EXPLAI14 IN REMARKS BY OPERATOR BELOW. <br /> LEAK RATE PER HOUR: + - ' 0023 <br /> REMARKS BY OPERATOR <br /> I <br /> i <br /> NAME OF OPE RAT OR,'p ,4R .�. <ZetjO . <br /> SIGNATURE ��r rel f / c�i <br /> DATE 7- 15--,f 7 <br /> i <br /> I <br />