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Underground Storage Tank System Tanks, Piping, Tank Sumps & Overfill Buckets Page J- of 3 <br />Secondary Containment Certification Form <br />Testing Contractor: �5 /-Sb�- Test nate: _;,^71-01 _ <br />[Facility ID: t7 - �, <br />Tech. Name: _� 0 .4� acility Address:�!'�v►^v+�-� ST Contractor Address: �.-- - op�-- <br />ocJc c•. G - <br />Turbine Sum s -- <br />UST Annular S ace -- r�^ Tank #A <br />Tank #f Tank #2 Tank #3 <br />Tank #1 Tank #2 Tank #3 Tank #4 -- <br />Product 87 89 91 D 87 89 �D 87 89 91 D 87 89 91 D Start Time (to) <br />Water Level <br />Capacity �U h� -- 1 Time (tj) <br />— Water Level G�`�" Ml I��+!/ I Yes►/ <br />Tcst Start Time 1SfC L.�+ s Z•� �— __ <br />Time (tL �� �— <br />Initial Pressure � � / IM _ L�ODc I ��� <br />p Water Level / <br />Test End Time ; Ss t•a <br />Time (t3) <br />Final Pressure (� - Water Level <br />Fail Fail Pass Fai! Pass Fail �(�fs7.,�,� <br />Test Results Time (t4) �Sf7' <br />S h SOS kph <br />Signature Water Level •O <br />Test Results Pa Fail as, Fail 8 Fail ' Pass Fail �M <br />Overt Buckets Jl B k 1 Signature <br />Product <br />Overfill 41 <br />t8 89 91 D <br />Overfill #2 <br />889 91 D <br />Overfill #3 <br />87 896D <br />Overiill> <br />7 9 91 D <br />Start Time (to) <br />- <br />{ <br />89 91 D <br />87 8� D <br />Water Level <br />87 89 91 D 4 <br />Time (ti) <br />rrss✓. <br />Water Level <br />"o <br />Time (tz) <br />1005r/ <br />sf b Fail <br />S3bz,y <br />Water Level <br />Pass Fa' <br />Time (t,) <br />Water Leve! <br />Time (t4) <br />�Si �l� <br />1tfsT�'lf"r <br />�dff7�ir� <br />Water Level <br />43 L7• <br />Df <br />Test Results <br />Pass Fail <br />ass Fail <br />s Fail <br />ass Fail <br />Signature <br />Product <br />Test Start Time <br />Initial Pressure <br />Test End Time <br />Final Pressure <br />Test Results <br />Signature <br />Rev. 10101 White - Original Yellow - Arco Environmental Compliance Pink - Contractor <br />5" a -Of <br />Line #1 <br />Line #2 <br />- <br />{ <br />89 91 D <br />87 8� D <br />8 89 91 D <br />87 89 91 D 4 <br />rrss✓. <br />�D <br />"o <br />1005r/ <br />sf b Fail <br />Fail <br />a Fail <br />Pass Fa' <br />Rev. 10101 White - Original Yellow - Arco Environmental Compliance Pink - Contractor <br />