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r7 <br />AFFORDA-TE$T 416 2nd Straet <br />Wr <br />Gait CA 95632 <br />Spill <br />Bucket <br />(209) 744-0112 <br />(209) 744-0116 FAX <br />Test <br />Report <br />Wait time between applying <br />vacuum/water and start of test: <br />Test Start Time (TO: <br />Initial Reading (Rj): <br />JEIJI'#ST <br />DATE <br />Final Reading (RF): <br />SITE NAME f <br />C -f ... C;rjZ PHONE <br />)-q1,t?-- <br />ADDRESS -/-a/ <br />ENVi RO-Nevif- N H JUXONTACT: <br />Pass/Fail Threshold or <br />Criteria: <br />6 0 <br />.0 CES <br />PE R 10 PC/, , EA A <br />Inspector: <br />Not Present <br />3, SPILL. BUCKET TESTING INFORMATION <br />Test Method Used: S*9ydrostatic 0 Vacuum 0 Other <br />Test Equipment Used: <br />Identify Spill Bucket (23y Tank <br />Number, Stored Product, etc) <br />1 <br />Bucket Installation Type: <br />0 Direct Bury <br />K Contained in <br />Bucket Diameter: <br />Bucket Depth: <br />Wait time between applying <br />vacuum/water and start of test: <br />Test Start Time (TO: <br />Initial Reading (Rj): <br />Test End Time (TF): <br />Final Reading (RF): <br />Test Duration (TF — Tj): <br />Change in Reading (RF - Rj): <br />Pass/Fail Threshold or <br />Criteria: <br />6 0 <br />Comments — <br />Equipment Resolution: 11-5 <br />2 3 4 <br />0 Direct Bury OD.irect Bury 0 Direct Bury <br />0 Contained in Sump 0 Contained in Sump 0 Contained in <br />made prior to testing, and recommended <br />Test Water: �4Taken with 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: Lyle D. Nimmo <br />. ..... ICC 524 -9115 -UT <br />OTT! : 97 <br />Signature: -114.3 <br /># <br />