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Aug. 18. 2016 10: 19AM Do <br /> e Pump Co No. 5143 P. 3 <br /> SWRCD,January 2006 <br /> Spill Bucket Testing Report Form <br /> I. SPILL BUCKET TESTING INFORMATION <br /> Test Method Used: &Hydrostatic 0 Vacuum 0 Other <br /> Test Equipment Used;. Equipment Resolution- <br /> Identify Spill Bucket(By Tank 1 2 1 3 4 <br /> Nkniber,Stoi-edPro&ct,etc.) <br /> Bucket Installation Type: A(Direct Bury 00irect Bury 0 Direct Bury 0 Direct Bury <br /> 0 Contained in Sump 0 Contained in Sump 0 Contained In Sump 13 Contained in Sump <br /> Bucket Diameter, fill I I fl <br /> Bucket Depth, Iq <br /> Wait time between applying <br /> vacuumtwater and start of test: <br /> Test Start Time(T�: (0, 0 0 <br /> Initial Reading(Rj): sit <br /> Test End Time(T,,): 0 <br /> Final Reading(R 3 <br /> Test Duration(TF—Tj): / !a- 00 A <br /> Change in Reading(RF-Rj): <br /> Pass/Fail Threshold or e0og <br /> Criteria: <br /> bw <br /> IDFMI 0:011.11. All 0 a <br /> Comments—Lnehide la formarion on repairs made prior to testhig, and recommendedfallopo-up fbr foiled eLrj <br /> CIERTEFICATION OF TECHNICIAN RESPOMME FOR CONDUCTING TMS TESTING <br /> I hereby certify that all the Informatio#jonAdned/it Bels <br /> 113 rt l r e, ceurafe,and Ito fall compliance solth legal requirements. <br /> Technician's Signature: Date: <br /> AUG 18 2015 <br /> • <br /> UP,t <br />