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Nov 1.8 11 08:55a Elite IV Contactors 12094616342 <br />Mai 19 09 12:54p Ell* Iv Contractors Inc 20946 * F <br />P.5 <br />p.4 o� Z� <br />sWY,,Cr3, Jantlary 2006 <br />Spill Bucket Testing RePOrt F"A <br />st-vcftirm :rhe complaredfiV711 and,pri,,fOU'jyfrom tests (if applicable.). should be priold*d 1 10 the facility OjVjjCr1OpCratOrfC r lbm.itraljo the <br />Facility Nam= OA <br />TO( =(,tl - -j < '' <br />, <br />Facility Address:Facility Contact <br />Date;Loca on <br />I A gcac Y wim Notified of Testing <br />N, (ij prc:,enr urt 29 <br />W <br />TESTING CONTRACToR )=�MA,1103 <br />FE;T,-P,wy Name, <br />Licom"c <br />:ting Test U - -- — - - <br />3LB Conix-acEof WCC Servic6 Tech 0 SY, RCB TO—Pli —Teser- <br />DUCIMT. T.E$Tj,,qC,, MORMATI".Y; <br />3. SPH -,L <br />Tcst Method used: <br />k-M-ydroStArir, -ij va=m <br />sit Bury <br />p <br />TeSrFq4w=t7Jscd,tri <br />Jdcxitiiy 11.Buckct. (By Tank <br />I <br />3 <br />,Vumbc2-, stored Product. St - <br />7- <br />CI 9i <br />0 Direct my 0 Direct Bury <br />Bucket lzu-tauation Type: <br />gLCmtaincd in SIM* o contained in <br />33=kot Diameter: <br />RucicezDcpdh: <br />Z L <br />Wait time bctwoen applying <br />vacuumtw,tter and start of test, <br />I <br />-rest start Timc (T,)- <br />Tridal Reading (R.1): <br />il C <br />Test End Time (Tr.): <br />Fia4 Roadiat (Rp)." <br />Test Dumifioa(TF-T): <br />Cl =ZC in Rw dhz (Rj- - RI}:— <br />pasift] Tkcshald or <br />(include inlormA11011 an repairs mac prior lo texang-, tMel =Ommcnder! f <br />, <br />Comeets <br />ai <br />4 <br />sit Bury <br />p <br />0 Direct Bury <br />El Contained in Samp. <br />7- <br />CFRTMCATIONOFTFC)IN'ICL'hNR'&IqlONSIBIEFOR CONDUC INGTIUSTZSTING <br />i fa Wmpfi�mcr widt, legal requirm etdL. <br />,ra att ormadeff, cart 'poly Et trite, aceurWe- <br />I 1jeray rcrtify. d the. inf, <br />D <br />atc: V <br />Technicians Sigratarc.- <br />State -,iractor. Howcvrr, local-requirezricuts <br />t iEi <br />laws =d rogulatiom do not currently -rcqiim test p, to be performed by a quallfied <br />may be more zrtnn9=t, <br />. ....... ........ <br />