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SO# 1�19/c� O r: Site# <br /> MONITOR ELLS <br /> Well Number 1 2 3 4 5 8 1 7 8 9 101 11 1 12 <br /> Well Depth / �f f <br /> Depth to Water <br /> Product Detected <br /> AMOUNT in,inches <br /> Standard Symbols for diagram below: @Fill O Vapor Recovery <br /> /B V.R. w / Ball Float ® Monitor Well Observation Well <br /> (Outside Tank Bed Area) o (Inside Tank Bed Area) <br /> © Ball Float ® Tank Gauge Vent <br /> Manway I Iron Cross T Turbine <br /> OCatiop . l r -Include the.Vapor ecovery System. <br /> E [7�1 <br /> -. <br /> 171 71- D . . . . . . . . . . . . . <br /> Sup' ��uN N��p . . . . . . . . . . . . . . . . . . . . <br /> ►01� JO.� (QIL . . . . . . . . . . . . . . . . . . <br /> Q) CO) — -- <br /> 1 L_� <br /> . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . -� <br /> Vapor Recovery System & Vents were tested with which tank? <br /> Parts and Labor use <br /> General Comments <br /> When OWNER or local regulations require immediate reports of system failure-Complete the following: <br /> REPORTED NAME DATE TIME <br /> T : <br /> Phone# OWNER or Regulatory Agency FILE NUMBER <br /> Pnnt Cerb ed Testers Name Vacutec"Ce cation Number <br /> Certified T Date Testing Completed <br /> Fcrm-TatflM►wst <br />