Laserfiche WebLink
q ~ �� <br /> _ t <br /> i •?; r1 I.11�•,rC ""'� <br /> I'iCCOLI #9 �a. ' - LIndcrgrou11d Storagc Iar; <br /> CA 95205 <br /> HORNER SYSTEM <br /> ENVIROMENTAL HEALTH <br /> WrdER OF SITE ( �JUrJc/l t,IN;F is n mac. cVL oJ %;,c,- FERMIT/SERVICES <br /> UUP.ESS OF OWNER s, T C I Tl L J/��i��_n/ _STATE Z i P <br /> -'v?NER OF T•ANY. LtrJa�N U,Jiri c:-n �c n c I);,r r <br /> ADDRESS C•F OWNER ISS-27 'c' /Il,��, S'.—. CITY `/y"y�:,�. STATE ZIP 4�• � - <br /> >, l <br /> At'iE OF OPERATOR AT LOCATION[,nj.> =�1 n St./ . n/ %Ji.sri4/cr <br /> {DDRESS OF LOCATION /F,,s,< •� ,r ��/-_��;� S7_ CITY J STATE C'iJ Z I P <br /> 'LAME OF COUNTY <br /> is �, ./�,/� u�V�.j <br /> TAr�K r / ON PLOT PIAN LOCATION. STORAGE SYSTEM FILLED; DATE ,. ,s; T7 ME <br /> DATE OF TEST /-i,�• t� 7 TIME OF DAY: START (] >��- FINISH <br /> LENGTH OF TEST,)//,,. ,,,,;,,,;�.+ AIR TEMPERATURE � ?° <br /> D I SCR I PT I ON OF TANK-CAPACITY /,,/, Coo DIAMETER ,� ' METAL , ' I BERGLASS <br /> ``'nE OF S`'STEM- SUCTION X SUBMERSIBLE OTHER <br /> T`'PE OF VAPOR, RECOVERY SYSTEM ll/r�n!F_ <br /> TYPE OF PRODUCT BEING TESTED l>,r_;/-� MEASURED GRAVITY 3.2. COEFFICIENT <br /> TEMPEP..ATUR;__ OF PRODUCT <br /> IN TANY. -C? DEPTH 0f TANY. TDP FROM GROUND LEVEL J <br /> -------- <br /> DEP,H G %,DUIiO WATT? /f:, „c. ��` HEIGHT OF LIQUID LEVEL IN TEST STAND OR STAND P I PE <br /> L I NESS <br /> i <br /> TEST: CERTIFIED TIGHT: YES NO IF NO, EXPLAIN IN REMARKS 5ELOW <br /> �;•.: r <br /> -• <br /> i/) /V <br /> i <br /> -- I <br /> 1`14^,'1E OF .0P ERA TOR Z/_ /c <br /> SIGN('T U R C OF 0I'C R fa T O P .C'L2Z .=------- <br />