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/WOORRKSHEIET FOR SUIMITTTALL, TO GOVERNMENTAL AGENCY
<br /> 'S
<br /> OWNER/OrERATOR !C�ifJ �/UI����r �C/7 As;__SITE At)ORFSS Z /!/, �L
<br /> CITY— J TT�Cs�C.�`> J `J¢ COUNTYV G-j6pq
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<br /> MAILING ADDRESS /�� 9Szo5 ,
<br /> SITE AGENT C/tel. /� A�
<br /> TELEPHONEy f) 4
<br /> ARRIVED TEST SIT>�>VIOURS TANK LOCATION ,�LQp-L� �L-t /mow
<br /> ODUCt
<br /> DATF./TtMF STORAGE FILLED l LS RODUCT LEVEL ATS�y�AR��Rtw�A1. INCHES PFLOW TOP OF FiLL Nt11tTNA1, TAItF Ri2F._>/Z OOO
<br /> TANK MAT ERiALL{� Ar£ROR, TANK Ar JCA 'rTRS. FILLSiZE/TT£E OVERFILL CONTATNHP,NT TTPF. Sp-syc�c�J
<br /> Ari GRAVITTS0.6 AT _I�JDF.G, F. - API GRAVITY O6005 0 60F - COEFfiCIFNT OF F.RPANSION OF COP, 8S
<br /> VISAPLE VENTING ArrRFJ1RS TO RE AT, FILL END, L OFOSItE P1t HAS PURr TmE, HAS PALL CHECK, tntr,}tOtJN, OitlFit
<br /> VISABLE vArOR TRAPS TO BE pI,ED: PALL CHECKS, MANWATS, RF,TURN LINES, OTHER
<br /> PHASE II VAPOR AECOVERT STSTiM! PALANCED, AS£IAAmik ASSISTED, LONG RtTN WELLS, MARIFOLDE.D, NONE, OTHER
<br /> PIR1rm STSTp} SiiCTION "mm,"r MAKE iTODE[, PIPE LINE LEAK Detectors y", NO; of ArFLi
<br /> CHARTED 917E Zl Lo EST. LINES Q,UANTiTT /4p PRODUCT ADDED TO FLOOD STSTF71_4 SYSTEM TORAL GAT.1.OItAGF.
<br /> AiMIF1tT CONDDITTIFH
<br /> ONS- Tr! PRF..TEStdp rcnTrST 6 OVDT, RAINING, W}NDY, pREE7.T, NIGHT, 07NFR
<br /> .4 FSI DR0405IOPOURS TEST TO START//4f4C)potIRS FSI TO BE FiAINTAINFD ON TAi1R HOT70F1 DURING IFS7 PERIOD
<br /> / A FSI
<br /> 1 A. GRAPE, To TANK ROT—" ! Y`
<br /> R,ig GRAPE TO TALAR TOP
<br /> s�i1'.OF C. TANK P1A",,R '`l
<br /> P. TEST LEVEL AROVE 0PADE
<br /> G �
<br /> 46- � E. lK1ERNAL GRDIRtP MATER ABOVE TANK
<br /> F— RPttn+ in. R ,oslsi rs1
<br /> 01
<br /> A F. TOP OF FiLL TO FOOD. AT ARRTVAL
<br /> G. Tor or FiLL TO TOP Or TANK Z-/
<br /> N. TPST'T.1lTEC'Tb ROTTON of TANK 16 Ov±
<br /> MATPR 1 BOE PST PER INCH of rwnmCT Agigluo
<br /> TANK _N / TEST HEIGHT PRESSURE FORMULA
<br /> H. PSIP'SI`TTT E. rSl NF1 Psi
<br /> RrP1ARKS
<br /> RESULTS
<br /> i'lIE FLNAT, '�ES'�' PERIOD AS S11OWN ON THE ATTACHED COMCUTER GENERATED DATA RrF1,F,C'IS A
<br /> iAS / GAIN OFr—,O/,I' GALLONS PER HOUR, WITii A 99% CONFIDENCE LEVEL OF +/- ��j�ps p,Ph•
<br /> THE HORNER EZY CHER II TEST 14ETIIOD COMPLIES WITH EPA AND THE STATE OF CALIFORNIA PERFORMANCE STANDARD OF 0.05 GPH
<br /> FOR TANK INTEGRITY TESTING. (SECTION 2643 CALIFORNIA CODE OF REGULATIONS) BASED UPON THIS STANDARD, T11E RESULTS
<br /> SHOWN ABOVE., 4w DOES NOT INDICATE AN UNAUTHORIZED RELEASE EQUAL TO OR GREATER THAN THE 0.05 GFH STANDARD.
<br /> INTEGRITY TANK TESTING SE TCF';' 166 FRANK WEST CIRCLE, STOCKTON, CA., 95206, (209) 466-8036 or (/800) 262-8318
<br /> CERTIFIED TESTER L� ""' STATE LICENSE 0 ``� TEST DATF, f I
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