Laserfiche WebLink
416 2nd Street Galt CA 95632 Spill <br /> AFFORDA-TE$ (209) 744-0112 (209) 744-0116 FAX Test Report <br /> TEST DATE <br /> SITE NAME e4ffePASC/49- W4�S PHONE ( Z01 <br /> ADDRESS d2-30 Ac/lor/c, 4116 CONTACT: <br /> Sr �v ey'd <br /> Inspector: �s Present / Not Present <br /> 3.. SPILL BUCKET TESTING INFORMATION <br /> Test Method Used: Hydrostatic ❑Vacuum ❑Other <br /> Test Equipment.Used: -" Equipment Resolution: , t(0 " <br /> Identify Spill Bucket(By Tank 1 �„ 2 3 4 <br /> Number,Stored Product, etc. Cl I D i E- <br /> irect Bury Direct Bury Direct <br /> Bucket Installation Type: Bury Direct Bury <br /> ❑Contained in Su ❑Contained in S ❑Contained in S ❑Contained in Su <br /> mp <br /> Bucket Diameter: `l t t <br /> Bucket Depth: 1 °%� t 3 YZ. 13 <br /> Wait time between applying _ <br /> vacuum/water and start of test: �— <br /> Test Start Time(TO: 8 8 84-5 <br /> Initial Reading(RD: 1 Z `( <br /> Test End Time(TF): q 4 r� 11 <br /> Final Reading(RF): 'Z` t Z sI e <br /> Test Duration(TF—Tj): Lie— 11— W <br /> Change in Reading(RF-RI): <br /> Pass/Fail Threshold or _ <br /> Criteria: <br /> .Comments-(include information on repairs made prior to testing and recommended follow-up for failed tests) <br /> Test Water: ®Taken with tester ❑Left on site _ <br /> 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#: 5263322-UT <br /> Signature: - -- OTTL#: 04-1676 <br />