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7� <br />® <br />AFFORDATE$T <br />416 2nd Street <br />(209) 744-0112 <br />Ga . It CA 95632 <br />(209) 744-0116 FAX <br />Spil l Bucket <br />Test Report <br />Bucket Installation Type: <br />jotqrect Bury <br />El Contained in Sump <br />TEST DATE -7 <br />SITE NAME X400 -1'n r <br />I <'3-11 <br />PHONE( <br />ADDRESS La <br />CONTACT: f-5; <br />J; <br />07 <br />Inspector. <br />Wait time between applying <br />-vacuum/water and start of test: <br />Present 1)/ Not Present <br />3.. SPILL BUCKET TESTING INFORMATION <br />Test Method Used:4Mydrostatic 0 Vacuum 0 Other <br />Test Equipment Used: f Equipment Resolution: <br />Identify Spill Bucket (By Tank <br />Number, Stored Product, etc.) <br />1 e <br />2 .3 <br />Bucket Installation Type: <br />jotqrect Bury <br />El Contained in Sump <br />0 irect B 0 Direct B <br />ury ury <br />0 Contained in Sump 0 Contained in Sump <br />0 Direct Bury <br />El Contained in Sump <br />Bucket Diameter: <br />Bucket Depth: <br />Wait time between applying <br />-vacuum/water and start of test: <br />Test Start Time (Tj): <br />Initial Reading (R1): <br />Test End Time (TF): <br />Final Reading (RF): <br />Ve- <br />Test Duration (TF — Tj): <br />Change in Reading (RF - Rj): <br />Pass/Fail Threshold or <br />Criteria <br />%_OMMCn1S--7(znC111deinjormaqo repairs made prior to testing, and recommended follow-up for failed tests) <br />Test Water: OTaken with tester RLeft on site <br />I hereby certify that all the information contained in this report is true, <br />accurate, and in full compliance with legal requirements. Techniciam' Lyle D. Nimmo <br />!CC #-: 524 -9115 -UT <br />SignatUF'a: <br />71 -114.3 <br />97 <br />