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AFFORDA-TE$T 416 2nd Street Galt CA 95632 Spill Bucket <br /> (209) 744-0112 (209) 744-0116 FAX Test Report <br /> d TEST DATE S O <br /> SITE NAME rA5T A ` C A5 y 144 r PHONE ( 24fl ) 9`}a-$00l <br /> ADDRESS 2`F`} qRahfA(b CONTACT: P"/;r <br /> ac,KTon) CA. <br /> Inspector u4 SA►JJoNot Present <br /> 3. SPILL BUCKET TESTING INFORMATION <br /> Test Method Used: XHydrost 'c D Vacuum D Other <br /> Test Equipment Used: p-PE L O - Equipment Resolution: <br /> Identify Spill Bucket(By Tank 1 2 3 4 <br /> Number,Stored Product, etc) <br /> Direct Bury Direct Bury D Direct Bury D Direct Bury <br /> Bucket Installation Type: D Contained in Sump D Contained in Sump D Contained in Sunip D Contained in S <br /> Bucket Diameter: 11 11 - <br /> Bucket Depth: Z 9 <br /> Wait time between applying <br /> vacuum/water and start of test: <br /> Test Start Time(Ti): t Z o 1 1 ZO <br /> Initial Reading(RO: ( ( A- 1 ' <br /> Test End Time(TF): 7- 7-v 2Zv <br /> Final Reading(RF): <br /> Test Duration(TF-Tt): <br /> Change in Reading(RF-Rj): <br /> Pass/Fail Threshold or <br /> Criteria: <br /> Em <br /> Comments-(include information on repairs made prior to testing, and recommended follow-up for failed tests) <br /> Test Water: Taken with tester Left on site <br /> LOW <br /> I hereby certify that all the information contained in this report is true, <br /> accurate, and in full compliance with legal requirements. Technician: , Zane A. Nlmmo <br /> ICC#: 5263322-UT <br /> Signature, OTTL#: 04-1676 <br />