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�, <br />TANK �; Data ,(-art for Tank System Tigj less Test ItAIWE�`-' <br />petro Tate <br />TAN f <br />OWNER Property U <br />Tank(s) XID <br />elephone <br />13. CERTIFICATION <br />Date <br />649 <br />Sonal No. of Thermal <br />Savor <br />This Is to certify that these tank systems were tested on the date($) shown. Those Indicated as " ht" miet the criteria established in <br />the National Fire Protection Asociation Pamphlet 329. A & A TANK TESTING <br />TOM BRADSHAW SVD., 5u)TE 103 4g --- <br />.T��qn rt�` �r Comw ny. evi Signature <br />414812383 5630 ft i til ui to #1 Bakersfield , CA. 93313 <br />Address <br />I achnicuna <br />nemv <br />10-992 3202 HAMMER STOCKTON M. <br />Z• Lo=(N <br />Nsme Address Telephone <br />3. <br />REASON FOR <br />F, ii i system Ti ghwess Test <br />TEST <br />(Explain Fully) <br />Corporation y' <br />Kurt Fischer I bbil 3-2 - % <br />4. <br />WHO REQUESTED <br />Tit Company D ole <br />or A11itl4llyQ` 693-5985693-5985y <br />TESL' AND WHEN <br />612 S. Flow r St. L.A. CA. 90017 �L71."!J) <br />telephone <br />Address <br />5. <br />WHO IS PAYING <br />t <br />Mobil Oil U°n Telephone Ili <br />Title <br />FOR THIS TEST? <br />Company. Agency or Individual Person Authorizing <br />Billing Address City State zip <br />Attention at: Order No. Other Instructions <br />Identify by Direction <br />Capacity <br />Brand/Supplier <br />-Grade <br />Approx. Age <br />Steal/Fiberglass <br />6. <br />TANK(S) INVOLVED <br />SOUTH <br />1 000 w/o <br />DIESEL <br />Location <br />Cover <br />Fills <br />Vents <br />Siphons <br />Pumps <br />1. <br />INSTALLATION <br />311 <br />DATA <br />North inside driveway. <br />Concrete, Black Too. <br />Size, Tltefill make. Drop <br />Remote Fills <br />size. Manlfolded <br />Which lateral <br />SuctionRemote, <br />Make If known <br />Rest of station, etc <br />Earth, etc. <br />tubes. <br />Is the water over the tank <br />8. <br />UNDERGROUND <br />Yes No <br />WATER <br />Depth to the Water table <br />Tanks to be Pilled hr. Date Arranged by Name Telephone <br />9. <br />FILL -UP <br />ARRANGEMENTS <br />Extra product to "top off- and run TSTT. How and who to provide? Consider NO Lead. <br />Terminal or other contact <br />' <br />for notice or inquiry Company , Name Telephone <br />A & A Tank Testing <br />10. <br />CONTRACTOR, <br />5630 District Blvd. - Suite #103 <br />MECHANICS, <br />any other contractor <br />Bakersfield CA. 93313 <br />involved <br />11. <br />OTHER <br />- - <br />INFORMATION <br />OR REMARKS <br />Additional information on any items above. Officials or others to be advised when testing is in progress or completed. Visitors or observers present <br />during test etc. <br />Tests were made on the above tank systems In accordance with test procedures prescribed for FPI T11P <br />"art° <br />as detailed on attached test charts with results as follows: <br />12. <br />TEST RESULTS <br />Tight Leakage Indicated Date Tested <br />Tank Identification <br />2-2-87 <br />0 YES -.017 G <br />13. CERTIFICATION <br />Date <br />649 <br />Sonal No. of Thermal <br />Savor <br />This Is to certify that these tank systems were tested on the date($) shown. Those Indicated as " ht" miet the criteria established in <br />the National Fire Protection Asociation Pamphlet 329. A & A TANK TESTING <br />TOM BRADSHAW SVD., 5u)TE 103 4g --- <br />.T��qn rt�` �r Comw ny. evi Signature <br />414812383 5630 ft i til ui to #1 Bakersfield , CA. 93313 <br />Address <br />I achnicuna <br />