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• Site# yf�Z <br /> S O# O � <br /> MONITOR WELLS 6 7 g g 10 11 • 12 <br /> Well Number 1 2 3 4 5 <br /> Well De th y '/ <br /> De th to Water <br /> Product Detected <br /> AMOUNT in inches Fill ® Vapor Recovery <br /> Standard Symbols for diagram below: 0 Observation Well <br /> /e V.R. w / Ball Float O Monitor Well OInside Tank Bed Area) <br /> (Outside Tank Bed Area) O vent <br /> © Ball Float GO Tank Gauge <br /> MM Manway <br /> �I Iron Cross nT Turbine <br /> Location Diagram-Include the Vapor Recovery System. <br /> . . . . . . . . . . . . . . UA IA <br /> . . . . . . . . . . . . .UA EA <br /> . . . . <br /> . . . . . . . . . . . . . . . . I. <br /> . <br /> U/1 .9 <br /> tfTo- 111 <br /> . . . . . . . . . <br /> . _ . . . f�7S_ O © 0 <br /> . FJt . . . <br /> . . . . . . . . . . . . :3 . . . . . . . . . <br /> . lFl O <br /> v <br /> nn <br /> ' S <br /> {Vapor Recovery System & Vents were tested with which tank? <br /> Parts and Labor used <br /> General Comments / 612a/ ao, euA)-v 7a_ IJe, <br /> When OWNER or local regulations require immediate reports of system failure-Complete the following: <br /> REPORTED NAME <br /> DATE TIME <br /> Phone# OWNt=R or Regulatory Agency FILE NUMBER <br /> Print CerU ed Testers Name Vacutec Certification Number <br /> Dc/"L) er i" l 32 <br /> Certified Testers SignatuDate Testing Completed <br /> re <br /> J4 &/ - /�/- <br /> Fa TzrWAtw <br />