Laserfiche WebLink
Data Curt for Tank System Tight►ess Test <br /> d9- APR <br /> PLEASE PRINT PEI 0- 'CK R80. <br /> 1. OWNER Property LONE STAR INDUSTRIES P.O. BOX 5252, PLFASANTON, CA 94566 <br /> Tank(t) NNne AddrNt 1111 TereOhone <br /> D TLEY 415 49'3-1420 <br /> N,erne Address 1leereeerltetiee Telephone <br /> L OPERATOR AMERICAN TRANSIT MIX 651 McARTHUR TRACY CA 95376 <br /> Nanle Add1eee <br /> Telaphome <br /> 3. REASON FOR RDGULATI <br /> TEST SUBCHAP'T'ER 16 OF CHAPTE72 3 OF TITLE 23 OF THE CALIFORNIA AUCMSTRATIVE CODE <br /> (Explain Fully) <br /> 6. WHO REQUESTED OWNM <br /> TEST AND WHEN Nam Tiffs Corno.ny,or Affilreon Deft <br /> Addgq Telephone <br /> 5. WHO IS PAYING CANER <br /> FOR THIS TEST? Company,Agency or Indiyiduai Person Authorizing Tice Telephone <br /> billing Address City Sftft Zip <br /> Attention of: Order No. Omer Instruchont <br /> Ids"by D"etion Capacity Brand/Supplier Grade Approx.A" Steel/Fiberglass <br /> 6. TANK(S) INVOLVED EAST TANK 1,000DIFsSEL <br /> Location Cover Fills Vents Siphones Pumps <br /> 7. INSTALLATION REAR OF CONCRETE 2" A" SUCTION <br /> DATA SHOP <br /> North in Moe driveway. Concrete.black Too. Sue,Tis"turtle,Drop s,xp�mph <br /> Hear of au"n,sit, Eerth.etc. tutiee.1lernoft Fins fife.MenMolded Milch to""? Dake it shown <br /> 8. UNDERGROUND Is the wow over the tacit <br /> WATER Depth to the water table <br /> r« � No <br /> s. FILL-UP e Arranged Tarns to be filled hr. Date by_ <br /> Neese t.f.ohem. <br /> ARRANGEMENTS Extra product to"top oho"and run TSTT. Now and who to provide? Consider NO Load. <br /> Terminal or other contact <br /> for not"or inquiry <br /> Comr»nr <br /> Nerrre Telephone <br /> 10. CONTRACTOR, <br /> MECHANICS, <br /> arty other contractor <br /> tnvofved <br /> 11. OTHER <br /> INFORMATION <br /> OR REMARKS ATAMM-A QQKk=. MAR 1989 <br /> Additional information on any nems above.Officials or others to be advised when testing is rn progress Of cor+pleted.Vrsnom or observers present <br /> during test etc. <br /> Tants tfrafe maide on the above tank systems in accordance with vel procedures prNerIII toe P , RVICES <br /> IL TEST RESULTS as detailed on setaehed test charts with resuus as tosote9: <br /> Tank IdeMrfic R n Tight Leakage IMreaNd 1 Daae Tested <br /> D 27 02-1 Q—Ag <br /> -- <br /> 13. CERTIFICATION 9W�sy�p��tainkayiewarroegad the dabs(a)dhows T1kew wdleaMa• 'Tiq�M^maim wai olgrlai wRaibsdwd by <br /> 2-10-89 BILL CAMPS= PETRO.-C1 M, Dr. <br /> Deas <br /> 1854 414811816 <br /> — _ _ 271 OPPO'f2riL1n1I ST. , <br />