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SO# k <� Site# <br /> MONITOR WELLS <br /> Well Numberl 1 1 2 1 3 1 4 1 5 1 6 1 7 1 8 1 9 1 101 11 1 12 <br /> Well De th <br /> De h to Water 6 <br /> Product Detected <br /> AMOUNT inirtcheal <br /> Standard S <br /> ymbols for diagram below.. Fill �V Vapor Recovery <br /> /B V.R. w / Ball Float ® Monitor Well ► �p Observation Well <br /> (Outside Tank Bed Area) (inside Tank Bed Area) <br /> B Ball Float © Tank Gauge O Vent <br /> M Manway I Iron Cross Turbine <br /> ®cation Maura -°ln l►,rlp tnp VagRec y system , z � <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> se/•) ROA, ,vim <br /> . . . . . . . . . . . . <br /> . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . �;� . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> -�",��`;`�� l✓'G � . . . . . . . . . . . . . . . . . . <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 DATE TIME <br /> TO: <br /> Phone# OWNER or Regulatory Agency FILE NUMBER <br /> Pnnt Certs ed Testers Name C.::::'- ,, .NIT Vacutec" Ce ca;o-n Number <br /> W.DEMI LU.KEHART <br /> OTTL: 91-1128 <br /> Certified Testers Signature Date Testing Completed <br /> Farm-Tar�IcyLtw <br />