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u A 9 <br />416 2nd Street Galt CA 95632r, <br />AFFORDA-TE$T ii(209) 744-0112 (209) 744-0116 FAXTEST DATE <br />r <br />922 <br />♦ s <br />Inspector: <br />/ Not Present <br />Test Method Used: <br />Hydrostatic <br />0 Vacuum <br />0 Other <br />Test Equipment Used: <br />p E U <br />Equipment Resolution: <br />Identify Spill Bucket (By Tank <br />Number, Stored Product, etc. <br />Bucket Installation Type: <br />1g,Z <br />❑Direct Bury <br />Contained in S <br />2 <br />❑Direct Bury <br />Contained in Sum <br />3 <br />' <br />Direct Bury <br />0 Contained in S <br />4 E <br />0 Direct Bury <br />Contained in <br />Bucket Diameter: <br />12- <br />q Z <br />! Z- <br />' Z <br />Bucket Depth:' <br />' 2 '/Z„ <br />' 2 'A <br />1 3 <br />Wait time between applying <br />vacuum/water and start of test: <br />Test Start Time (TO:Gj' <br />c, <br />ct 7-c, <br />`i2 Q <br />Initial Reading (RO: <br />Test End Time (TF): <br />1020 <br />(0 20 <br />Final Reading (RF): <br />i 1 ?�S <br />t c> <br />Test Duration (TF — TI): <br />Lie- <br />{Q..Change <br />Changein Reading (RF - RI): <br />Pass/Fail Threshold or <br />Criteria: <br />Comments. - (include information on repairs made prior testing and recommended follow-up for failed tests) <br />Test Water: ❑Taken w#—b tester Lefton 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-, , <br />ICC #: <br />OTTL #: <br />Zane A. Nimmo <br />5263322 -UT <br />04-1676 <br />