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AFFORDA-TE$T 416 2nd Street Galt CA, 95632 Spill Bucket <br /> fft� (209) 744-0112 (209) 744-0116 FAX rest Report <br /> TEST DATE <br /> SITE NAME Jai " � .1— /'_ ��1� <br /> � PHONE r ZO S <br /> -7> <br /> ADDRESS �� �� S, ff1l>/� {���'I CONTACT: <br /> 7V-/tQz <br /> Inspector: Vj I `L--I Present / Not Presen=- <br /> 3. <br /> SPILL BUCKET TESTING INFORMATION <br /> Test Method Used: drostatic ❑ Vacuum ❑Other <br /> Test Equipment Used: 12, - v� Equipment Resolution: <br /> Identify Spill Bucket(By Tank 1 2 3 4 <br /> Number, Stored Product, etc.) a MAI — L-,CvE <br /> Bucket Installation Type: ❑Direct Bury ❑Direct Bury ❑Direct Bury ❑Direct Bury <br /> N:Contained in Sum ontained in Sum 02nContained in Surnp ontained in Sum <br /> Bucket Diameter: /,P-- <br /> Bucket Depth: 3— <br /> t Wait time between applying <br /> vacuum/water and start of test: — <br /> Test Start Time(Ti): /3 p b 13 o v 13 d o 13 o a <br /> Initial Reading(Rj): /� t <br /> Test End Time(TF): <br /> l <br /> Final Reading(RF): l 2 — i z- <br /> Test Duration(TF—TI): �2 / � / <br /> Change in Reading(RF-Rj): <br /> Pass/Fail Threshold or <br /> Criteria: <br /> aYs�a i�;�l ''t� � tela mn <br /> e aj1 a ki1 ,J � P t u r u,x ,ai w n 6 S m rc <br /> i • ., r I�'.r � ry 4+4� 1 i n tiny) �y r>,y,f}✓t+A <br /> �.,..,��. , <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 /> I hereby certify that all the information contained in this report is true, <br /> accurate, and in, t1 0 liartcewith legal requirements. Technician: , Zane A. Nimmo <br /> - ICC #: 5263322-UT <br /> Signatures OTTL#: 04-1676 <br />