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AFFORDA-TE$T 416 2nd Street Galt CA 95632 Spill <br />(209) 744-0112 (209) 744-0116 FAX Test Report <br />TEST DATE 3A. AV—; <br />=41 <br />SITE NAME p pt -Z p 5"`¢ 8 PHONE ( Zo <br />ADDRESS <br />CONTACT: <br />Inspector: <br />/ Not Present <br />,%—VA1X1.1®a1ca - (incivae injormanon on repairs matte prior to testing and recommended follow-up for failed tests) <br />Test Water: Taken with tester ❑ Left..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. Technician:, Zane A. Nimmo <br />ICC -UT 5263322 <br />Signature:' OTTL #: 04-1(37R <br />