|
I '
<br /> WORKSIIrr'I' FOR 9111WH'I'TAL, TO GOVERNiU;NTAL AGuICY
<br /> mmFR/OrF.RATOR ST 4-e '�iV/�/� dam'/ �1'i_StiE ADDRESS '/9 /JZ, A • 1� 4 I"
<br /> CITY 1 U -
<br /> - COlD1iT
<br /> MAILTiiG ADDRESS
<br /> SITE Art" ,,C//yy��� JC_ /mil.-f�2 94,:;7
<br /> ARRIVi� TEST SIf 714:2"OURS TANK LOCATION A� l'RODUCT
<br /> DATE,/T1NF, STORAGE, FIi,LP.P n0/9 dOV2 FRODUCt LFVFI, A.TARRIVAINCNES AFLOW Tor OF FIt.I, NOiiINAL TANK RT7.F.
<br /> TALAR MATF.RiAi. ArrROx, TAiDC A(3P!yl TRS. FIum..F./T'YFF. _11_ (NFRFILL CONTATi MIT TTEF, �J_G{�
<br /> Ari rRAVIra.0 AT SO DEC. F. - Art rRAVTTY OA��� FOF • COF.FFICTrNT OF MANSION OF .000 j6 - CDF
<br /> VISARLE VEiTTING APPRP.ARS TO AE ATtICI, YTfi, FILL Oros ITE F.Tfi, i TIRI NAS AAf.L CIIFGF IiTIRNOWII, O1T1FR —
<br /> VISAALF. VAPOR 7RAFS TTi BE A1,1!D: AAT,L C"F.CRS, HANWATS, RF,TURN I,ITIF.S, OMER
<br /> rRA.SF, II VArOR RECOVERY STST@i: ALANCFD SPIMTOR ASSIS7FD, IABP RIIN WELLS, HANTFOLDED. NONE, OMER
<br /> TIRITTNG STSTEII: CTIO TTDRAINE HAfCF, W HODF.I, _-- rTPE LINE LEAK Detectors YP,S, ito• CrrLIC
<br /> CPARTF.D RI7F. 3 7 Z.. FST, LINE, QIJANTITY Iy PRODUCT ADDED TO FLOOD STSTP?i_3—STST@1 TORAL CA1.f.ONArr,
<br /> AMRIE?T COND``ITIOtiS: Inv! rRF.TF.ST�-rOS7F5T 111TNY CLOUDY, RATNTIm. WiNTly. ARHF.7Y, NIr"T OTTIF,R
<br /> 4 rSI DRWW049—NO1MS TEST 70 STARTLkM!: "OARS rSI TO AE ItAINTAMM ON IAAF, AOTTOH DURINr TEST FF.RiOD �� PST
<br /> _ A. rRAr.. TO TAtiX 11M it
<br /> ZS R. TTAPF. m TANK TOP 7✓
<br /> O �
<br /> r,. TANK R1Avr.TvR77; �
<br /> O. TPST I.M.I. APOVE CPANE
<br /> P. EXTERNAL rtmOrm MATPR ARM TAIIX --�---
<br /> _L ✓ Rrirtttl 1 .0\61 P51
<br /> r. Tor Or rill, TO PAOO. AT ARRTVAL
<br /> A��y r. mr Or riLL TTI TOP OF TAMC
<br /> TPST"I.RTPL-TO ROMIM OF TAPIR
<br /> w�{ MATER iNp1DE PSi TPR 1NLT1 OF rpnmrr
<br /> r TEST IIEIQR PRESSURE FORMICA
<br /> 11. PSI F, fSl NFI f'SI
<br /> REMARKS!
<br /> RESULTS
<br /> 111 1, 1' ?T i'i?11101) All S11014N ON THE, A l'ACIIr1) COrimi,i rR (,rNrRA'i'l:l) DATA Rrri,rC f`: A
<br /> LOSS / A i Or,V, GALLONS PER 1101111, W I T11 A 99% ca)Nr i m.mcr i,rvrl, 0r -F/– 1 2106 pill].
<br /> Ti1E HORNER EZY CHEK II TEST ME11101) (3OIiri-irs Wi'IT1 F,rA AND THE SPATE OF CA1.TrORNIA rERFORMANCE STANDARD OF 0.05 GPil
<br /> FOR TANK INTF.CR T}' TE SECTION 2643 CALIFORNIA CODE. OF RECULATIONS) RASED UPON TIIIS STANDARD, TILE RESULTS
<br /> SHOWN ABOVE: DOES N INDICATE AN UNAII'I11ORT7,ED REI,r,ASE F.Q1IAL TO OR rREATF.R 711AN TuE 0.05 GPII STANIIARD.
<br /> INTF,CRiTY TANK. TESTING SE 'TCr.S, 166 rRANY, WEST CIRCLE. STOCYTON, CA., 95206, (7.09) 466-9036 or (S 26 -113711
<br /> CERTIFIED TESTER STATE LICENSE at Q- -QZ TEST DATE r 9?
<br /> --611 - �-------- - --
<br />
|