Laserfiche WebLink
P. O . <br /> 30487 <br /> Ca ����'■ v`7 <br /> Stor_kton, , California <br /> (209) 931-1828 <br /> TEST REPORT {' <br /> OWNER OF SITE ' <br /> ADDRESS <br /> f CITY Uro ZIP{� <br /> OWNER OF TAN{<S��) J77 /� 1, n1.c- <br /> OPERATOR <br /> y_C,�' O <br /> ADDRESS <br /> CITY�_STATE ZIP 1 <br /> OPERATOR A LOCATION - -- • � <br /> ADDRESS Q <br /> CITY STATECI21P12� <br /> NAME OF COUNT • <br /> TANK /1 ON PL T PLAN AGE OF TANK(A f(► k <br /> DESCRIPTION TANK: <br /> CAPACITY <br /> ,DIAMETER /D a MCTAL ✓ FIDERGLASS <br /> TYPE OF SYSTEM: SUCTION/; SUBMERSIBLE <br /> VAPOR RECOVERY SYSTEM OTHER <br /> PRODUCT BEING TESTED TYPE <br /> API SPECIEIC GRAVITY Lb 60OF MEASURED GRAVITYSyygg EEMM _ DUCT' TEMP,, . COE <br /> STORAGE FILIED'- DATE —• 1 tZ <br /> TIME <br /> TESTED - DATE + , START <br /> LENGTH OF TEST -t& F/INISH / 3� • <br /> MEASURED WATER IN TANK_ HEIGHT OF LIQUID LEVEL <br /> DEPTH OF GROUND WATER, <br /> PSI AT TANK BOTTOM,,L/ , <br /> RESULTS OF TEST: <br /> CERTIFIED TIGHT? - YES ✓ ; NO IF NO EXPLAIN IN REMARKS. , <br /> LEAK RATE PER HOUR: + or <br /> REMARKS BY OPERATOR <br /> NAME OF OPERATOR <br /> SIGNAT E OF OPERATOR <br /> DATE - -- <br /> i A <br /> �� <br /> ^` •.:x ;�:� l ''}y, r DRi 5 <br /> • ` f�MYY `T <br />