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AFFOR®A-TET 416 2nd Street Galt CA 95632 Spill BLgC et <br /> (209) 744-0112 (209) 744-0116 FAX Test Report <br /> ' IiIrAilW r� TEST DATE S yq a <br /> SITE NAME �ya�T 86'601i PHONE <br /> ADDRESS CONTACT <br /> o <br /> Inspector: 0 / / <br /> p N ��«/ Present / Not Present <br /> 3. SPILL BUCKET TESTING INFORMATION <br /> Test Method Used: ❑Hydrostatic ❑ Vacuum ❑Other <br /> Test Equipment Used: Equipment Resolution: <br /> Identify Spill Bucket(By Tank 1 2 3 <br /> 4 <br /> Number, Stored Product, etc.) g / 1 Z)/46F <br /> ❑Direct Bury ❑Direct Bury ❑Direct B <br /> Bucket Installation Type: m'Y ❑ ect Bury <br /> 6contained in Sump XContained in Sump KContained in Sump ❑C ntained in Su <br /> Bucket Diameter: ( / 1( <br /> Bucket Depth: 13 (3 <br /> Wait time between applying <br /> vacuum/water and start of test: �- <br /> Test Start Time(TI): ( l <br /> Initial Reading(Ri): 10 — <br /> Test <br /> o —Test End Time(TF): 1 0 1 Zv o d <br /> Final Reading(RF): p _ ( l — Lo <br /> Test Duration(TF—TI): y �� <br /> Change in Reading(RF-RI): $ .�— <br /> Pass/Fail Threshold or <br /> Criteria: <br /> µe � Y,�i,� OC��-���7"i 1y�r^ p �e;� y{a SM'V VYl-u,L 1�{.. .�: {EFj rNlf��:�9 E�4 7 F y� �?•-dl' � �i r� a, . <br /> �lepvgii.YS �?� <br /> w,<i f. a�P N. � �We i'„ } a». „t ...Yu ,�a kpaSSa11IY'd�s�: IiFfidit. t :SFit�11�11� y gi` i u'd5S2b..`�©T1�Al�t°j' <br /> Comments— (include information on repairs made prior to fes Ing, and recommended fo low-tip for failed tests) <br /> Test W-ater: Taken with tester F—]Left on site <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. Nimmo <br /> ICC #: 5263322-UT <br /> Signature: <br /> _ ,. ..... ___. -- --- --- OTTL#: 04-1676 <br />