Laserfiche WebLink
UHI1 )l' I ANK I L5 I INN iti CON I I <br /> P.U. DUX 30400 � LICENSED <br /> SIOCKTON, CA 95213 INSURED <br /> (209) 931- 1020 <br /> fAX (209) 465-3006 <br /> LICENSE #t92-1248 <br /> OWNriR OF SITE:J�)(--'J- _. 'Cvc} l-rl <1 LEONAQ ) E. CRISP <br /> AUDRF,SS: 0kVJJ1 :C111Jo <br /> OWNFR '.OF <br /> ZIP:. .._._._..- -....._ <br /> OPERATOR AT LOCATION:. _. _—�{il-mr�.[1� <br /> ADDRESS:------------ - -:__.. CITY:_ ZIP:_. ._ . <br /> COIJNTY:.� (� At- TANK#:_.1.- . - AGF: _ GAI,LONS:--L-t)I—L U-__-- <br /> MFTAL(I�0 FIBFRGT,ASS( ) SINGI,F WALC.EU(--?4 UOUl31.E WAI,LI?D( ) <br /> DIFSF,LN-) UN[.EADFT) ( ) PREMIUM UNL. <br /> SLICTION(1) SUBMRRSIBLF( ) OVF,RSPILI. CONTAINER"'YT-'S( ) NOQ6) <br /> SITEAR VAI,VI's"YES( ) N0(-4 1N-LfNF LFAK Dli'f1iCT'OR"YES( ) NO", <br /> VAPOR RECOVERY SYSTEM"YFS( ) NO(-,)K) 1F YIiS, PHASE I( ) PHASE II( ) <br /> TANK FILL. DATE:S-&'_ _ TIME: 1 /DU ._ <br /> TANK TEST DATF:8-)R <br /> LENGTH OF TEST: 1114'�._ <br /> TANK BOTTOM TO GRADE......I " TEST LEVFI, TO TANK BOTTOM.. S. <br /> TANK TOP T'0 GRADE............_.� �� __-" GROUND WATER ABOVE TANK......- <br /> � i / <br /> U[ AMIITIiR....:......................... iJ _ psi................................... <br /> .................... _ 3. -.. <br /> TEST' LEVEL ABOVE GROUND.�� NET 'PEST PRF,SSIIRF........................ . <br /> WATER IN TANK..................... All SPFCfFfC GRAVITY................... <br /> I)FPTH FOR TAKING SAMPLF....��G,.J_" TEMPERATURE....................................���_ _ <br /> TEMPERATURE, PROBE DEPTH....y� " API SPECIFIC GRAVTTYP 60' F......_._.3-218 . <br /> COEFFICIENT OF FXP..................O0o <br /> LEAK RATE PFR/IIR:. __ .__ /; 0�4 <br /> CERTIFIED TIGHT: YES�q NO( ) <br /> PRODUCT LINE TEST: SUCTION(/!) PRESSURE.( ) <br /> LRAK RATE PI"R/FIR: <br /> CERTIFIED TIGHT: YI."S(/) NO( ) <br /> � a <br /> DATE: � lq__ SIGNATURE 01' _-- <br />