Laserfiche WebLink
Champion P.O. Box 13059 <br /> Sacramento, CA 95813-3059 <br /> Precision Tank Testing CA 800-660-9443 <br /> License No. 73848 NEV 800-949-9443 <br /> (916) 927-1557 <br /> Fax: (916) 927-7345 <br /> HORNER EZY-CHECK CERTIFICATION <br /> Property <br /> Owner: 7OcKy-brl (,i'ti5C#0 2rc-f <br /> Address : /fU EL PJAJ4L 44, <br /> Tank Address : SAmz:�- <br /> *Notice to owner(s)* A copy of this test result has been filed with the proper regulatory <br /> agency. It is the responsibility of the owner(s) to contact the local Env. Health Dept. in <br /> his or her area of any tank failure within (24) hours of testing. <br /> Tank# Product Capacity Apx. Age Steel Fiberglass Supplier <br /> aic--SEL 10000 v <br /> ICSFL <br /> U Nlr•A-0c 0 <br /> N w <br /> Lc-AD6D Ia000 <br /> Tank( s ) were filled on : 2 Distributor : c.t_, r3RyAwT <br /> Date Time <br /> Extra product to top off:_No[c}-Yes[ ] Gallons <br /> Comments : <br /> TEST RESULTS INCLUDE <br /> Tank( s ) c/ Product Line( s ) y Vapor Recovery System v Vent Line(s) v <br /> Tank Tight Tight Leak indicated Leak indicated Date of <br /> ID# Tank(s) Line( 2 ) per hr . ( tank) per hr . ( line ) testing <br /> I Yes[ No[ ]YesPf�o[ ] <br /> �- Yes[' 1o[ ]Yes[`7No[ 7 -,00 5,3 -44 <br /> ulL N/w Yes[ o[ ]Yes [o]No[ ] -.03 3 -.00 a -r9 -q(. <br /> Yes[ ]No[ ]Yes[ ]No[ ] <br /> Yes[ ]No[ ]Yes [ ]No[ ] <br /> Yes[ ]No[�]Yes[ ]No[ ] <br /> TechnicianLicense Qg- ��o9 Date : <br />