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SO# own* 177,,;7F*— <br /> / *— S ite# <br /> MONITOR WELLS <br /> Well Number 1 2 3 4 5 6 7 8 9 10 11 12 <br /> Well Depth f5"�,l <br /> Depth to Water I <br /> Product Detected <br /> AMOUNT in inches <br /> Standard Symbols for diagram below. OF Fill OV Vapor Recovery <br /> /B V.R. w / Ball Float OM Monitor Well O Observation Well <br /> (Outside Tank Bed Area) (Inside Tank Bed Area) <br /> © Ball Float GO Tank Gauge O Vent <br /> MO Manway 0 Iron Cross Turbine <br /> Location Dia ram—Include the Vapor Recovery System. 061",zt ZZ <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> 97 97 IN4 Lk . . . . . . . . . . <br /> s�N &M Iva <br /> . . . . . . . . . . . . . . . . . . . . <br /> . . . C_ . . . . . . . . . . . . . . . . <br /> r- - <br /> S. <br /> ��L0 .OF <br /> III . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . .. <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> Vapor Recovery System &Vents were tested with which tank? <br /> Parts and Labor used <br /> General Comments <br /> When OWNER or local regulations require immediate reports of system failure-Complete the following: <br /> REPORTED NAME &,ed)f DATE TIME <br /> Phone# OWNER or Regulatory Agency FILE NUMBER <br /> Print Certified Testers Name Vacutec"Certification Number <br /> Certified Testers Signature Date Testing Completed <br /> Form-TankWLh9-0fW <br />