Laserfiche WebLink
0 <br /> siata Chart for Tank SysitGm Tightness Test <br /> PLEASE PRINT <br /> 1. OWNER Pmv.i-E� g <br /> Name Addrau Mpl.aentslM Tebpnore <br /> enR� <br /> Mma Addreu Repreenlelive Telephone <br /> 2. OPERATOR Tar No no. <br /> Name Addrau <br /> 3. REASON FOR <br /> TEST <br /> (E.pl.in Fully) <br /> 4. WHO REQUESTED <br /> TEST AND WHEN Nen" Tim Cumpen,orAXiIINbn Dat. <br /> Add. Telepnone <br /> 1City by Direction Mpkkoty Brandru lier Gude wpe Apo..Asteewl leu <br /> 5. TANK INVOLVED <br /> (n;Lrc.4 ion <br /> I <br /> Lisa additional lines <br /> for menlidded Lanka <br /> Lwnllon Laver FlIN Veb SlpMnn Pumps <br /> 6. INSTALLATION fd '4L c .�4 <br /> DATA 11 eovvl:0d- <br /> Noris intlde ddkewaY. Conroe.Beck Top. S%Titelill make,Drop S bn.Remota, <br /> Mar of station,Inc. Esse wc, tubes,Remote FIll. 517e.Manllolded lA'nicn tenial Maks X known <br /> 7. UNDERGROUND 1 It tM wale,over the renal <br /> WATER Mirth to the W.I.taws A t t ]1 L " U ❑yr ❑No <br /> 8. FILL-UP T.nkt to re nlad or. D.I. annINed by <br /> Name TwepllOe <br /> ARRANGEMENTS Extra product to lop ofn mod nin tank twtm. lfow and wdro to providai Conslder NO std. <br /> Termbei or other con Wd <br /> Iw notice o,lnc or, <br /> c�pplwpl, Nerve Tsl.pnore <br /> 9. CONTRACTOR, Paradiso Construction Co -- <br /> MECHANICS, <br /> any Omer contractor <br /> involved <br /> ! <br /> 10. OTHER <br /> INFORMATION <br /> OR REMARKS <br /> AddXbnel Iniwmetbn on any Nemo avow OlXclalt or wren to be adviw0 wbran IMIy k In proaresa or ampMlad.Viahon or oeeereen present durllq feet,MC. <br /> Teats ,M,Mod@ rail the sbnee tank systems ti accordenee with teal procedure prewmed for <br /> 11. TEST RESULTS r dNafled m etlachad teat charh with re.ulh a fotlowa: <br /> Tank Identifialbn Tpnl t.ek.,Ind.. Dee Te tec <br /> p —r0 1Oh <br /> -4 mS <br /> 12. SENSOR 13.The is to r»roy mat tlnea tw*.ya1«ns ware fleAed m the Gle(li).bows Those Mtdlested r-Tghr f"the anwr.nabwerd by the <br /> ACACER' FICATION National Fln Pmlactlon Association Pam;~321L <br /> \ TacnnicMra <br /> T Paradiso Construction Co. <br /> TMllrly contractor IXCMnp.nY_ BY, SlVnetwa <br /> $ed.I Np.pl tTerm.I - Gnluatlone a�S�\13� 9220 "Gt1 Street Oakland CA 94603 <br /> Senor <br /> Accrue <br /> 3 <br /> Gartlllullon 0 PNW27 <br />