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Afforda-Te$t <br /> 416 2nd Street Galt, Ca. 95632 TANK ANNULAR <br /> 209 744-0112 Fax 209 744-0116 SPACE TEST <br /> Site: Date: / / <br /> pp � <br /> Address: -7000 A� ,d C'n .. .. <br /> Ci : - . E S Equipment: EZY 3 LOCATOR PLUS <br /> Test Method Developed By: ❑Tank Manufacturer Industry Standard ❑Professional Engineer <br /> ❑Other(Specify) <br /> Test Method Uses: ❑Pressure Vacuum ❑Hydrostatic <br /> ❑Other(Spec) <br /> Measuring Equipment Used for Testing: M w i-P , P <br /> {, Tank# Tank# Tank# <br /> Tank Capacity: r)c)1) <br /> Tank Material: S�e <br /> Tank Manufacturer: <br /> Product Stored: <br /> Wait time between applying <br /> pressure/vacuum/water and starting <br /> test: <br /> Test Start Time: // -/-3 <br /> Initial Reading(RI): 0 }/ <br /> Test End Time: f -Z <br /> Final Reading(RF): <br /> Test Duration: <br /> Change in Reading(RF-Rj): <br /> Pass/Fail Threshold: <br /> Was sensor removed for testing? <br /> Was sensor properly replaced after �� S <br /> testing? <br /> Comments— (include information on repairs made prior to testing <br /> Technician: yl Dn.m - <br /> Signature: <br /> OTTL#97-1143° ' ICC#5249115-UT <br />