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F0r Ali Ali �ti dr �l �1i di dr �Ir I Ali Ali Ali dr Ali Ali <br /> .�1e !1�. .�1�. .�►�. .�P. .�1�.�1 .�1�. !1�. .�1�. .�1�. I .rl�. �jL .-.�-. .rl�. .�1�. .r►�. !1�. !1�. <br /> Fililz CERTIFICATE OF COMPLETION <br /> Interstitial Vacuum Test IVT <br /> For The <br /> PLASTEEL° Double-Wall Underground Tank <br /> I. Third Party Evaluation: This leak tightness Installation Location: <br /> test method has been third party evaluated per the <br /> Alternate EPA Test Protocols for Plasteel International. <br /> •a; The third party environmental consulting firm thata_ <br /> Mperformed the evaluation was: % <br /> zl <br /> ot; Ken Wilcox Associates, Inc. ffiffi <br /> .,: <br /> 19401 E. 40 Highway, Suite 100 !►` <br /> Independence, MO 64055 IV. Test Results: The interstitial vacuum lest was <br /> (816)795-7997 performed per Appendix B. The following data was a. <br /> 'z recorded: <br /> A copy of the evaluation is on file at each licensed Nominal Tank Capacity: <br /> PLASTEELw tank manufacturer and at: (Gallons) .,.. <br /> Plasteel International Inc. Primary Tank Product: <br /> 2541 State Street (air, gasoline, diesel, water) <br /> Carlsbad,CA 92008z. <br /> (760)729-1093 Required Test Period: <br /> (Hours, per Appendix B, Figure 6.0) <br /> �= II. Tank Description: Initial Gauge Reading: inches Hg. o_,. <br /> Date Time am/pm <br /> L51 F21 Capacity: Gallons <br /> Final Gauge Reading: inches Ho <br /> FN <br /> �►` Jacketed: Date Time am/pm 17AZI <br /> Total Elapsed Time Period: <br /> ��. Composite: (Hours) <br /> Compartmented: Yes No Pass Fail (Initial) <br /> a% V. Statement of Test: I certify that the PLASTEEL`' F.",'l <br /> U.L. Number Double-Wall tank described above has been tested leak <br /> tight per Appendix B of the PLASTEELI Tank <br /> .�_ Installation Instructions. <br /> Tank Manufacturer: Testing Company: <br /> ' Name: Name: ' <br /> FoA Address: Address: <br /> :i:. <br /> I <br /> Ill. Installation Information: Telephone: <br /> Tank Owner: <br /> .a; .�; <br /> Mizi Signature <br /> Name: — <br /> Printed Name <br /> = Address: <br /> Title <br /> Date ,•i <br /> IVT-CERT 699 <br /> �Ir dFrqtr �b r ♦ ♦r _ ♦tr qtr tr_ Ali <br />