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i <br />WORKSHEET FOR SUBMITTAL TO GOVERNMENTAL AGENCY <br />OWNER/OPLRAiOR /WAe:Z% <br />SITE ADDRESS Olu 'z— <br />CII1 Z_U COUNTY , LTd QCilnt J <br />HAILING ADDRESS 0�S �a /�Q1( f � d -X, 1*149 &7f_e �►�'L d <br />SITE AGENT D��Sj TELEPHONE <br />ARRIVED TEST 8ITF'/A"0/URfi TAM I DcATION �.�%' % ��S � pRODOCT <br />DATE/TINE STORAGE fILLED(p / PRODUCT LEVEL AT AR1tIVAL_ti*INCRES BELOW`ITOP OF FILL NOMINAL TANK <br />TANK MATERIALD� 4+!t- ArtROX. TANK AOe�YRS. fILLBIZE/TTFE 4 OVERFILL CONTAI10fENT TTTFNAlye2eywrl <br />API GRAVITY C716/ AT � DEC. F. - AFI GRAVITY OFS'��f 60F COEFFICIENT OF EXPANSION OF .000 �p�j/¢ Z Colt <br />VISABLE VENTING APPREARS TO BE ATt FILL END, OPOSITE HAS BURP TUBE, _BALL CHE UNKNOWN, Or"m <br />VISABLE VAPOR TRAPS TO BE BLEbtCHECKS NANWAYS RETURN LINES, OTHER 7-L- <br />PHASE It VAPOR RECOVERY BYSTEMs BALANCED. ASPIRATOR ASS28TED. LONG RUN U,�WELLS, MANIFOLDED, NORE, OTHER _ <br />r11f0'ING SYSTEMt SUCTION TURBINE HAKE %��C yJ�1 110DE lt[C! AIPE LINE LEAK Detector TES. . NOT AFPLIC <br />CHARTED SIZE 7 EST. LINE QUANTITTZ-0 PRODUCT ADDED To FLOOD StBTf��NYSTM TORAL GALLONAGE /Ih 7Z -- <br />AMBIENT CONDITIONSt TEHPt PRETEST �rrosnsT-� CLOUDY, MINING, WINDY, NlCllt. OTHER <br />.4 rSI DRonyO Nam TEST TO START 4PQNOURS P82 <br />TO BE MAINTAINED ON TANK BOTTOM DURING TEST PERIOD 44 PSI <br />R. CRAM TO TANK lei a _ QSY4 <br />• . GMM! TO TANS TO► <br />C. TANK DIA>iETBR <br />O. TEST LBV81. ABOVE OMD! 2 L <br />!. BxTBRNAI. oR0U10 MAnM ABOVE TANK <br />PSI <br />Bgl'fQl.,_,. .,,.,SIN. 1 .0761 P!1 <br />P. to of FILL TO ►ROD. AT ARRIVAL <br />44 <br />QS� <br />R. TDP OF MILL YO IV OF TANK <br />M. TEBT�um-Tit Doi ftm D► TANK <br />v' <br />Mat PER INCH Or ►RDDUCT <br />046 Z <br />TEST BEIM 1028SIIII! tow" <br />- 67t4x- _ if,.3� <br />REMARKS : Psi sF'i— NET s <br />n�yD 119 <br />RESULTS <br />THE FINAL TEST PERIOD AS SHOWN ON THE ATTACHED COMPU'T'ER GENERATED DATA REFLECTS A <br />/ GAIN OF: Bpd/ GALLONS PER HOUR, WITH A 999 CONFIDENCE LEVEL OF +/- ,00/ gph. <br />THE HORNER EZY CHER II TEST 14ETIIOD COMPLIES WITH ErA AND THE STATE OF CALIFORNIA PERFORMANCE STANDARD OF 0.05 GPH <br />FOR TANK. INTEGRITY TESTING. (SECTION 2643 CALIFORNIA CODE OF REGULATIONS) BASED UPON THIS STANDARD, THE RESULTS <br />SHOWN ABOVEt jAV DOES NOT INDICATE AN UNAUTHORIZED RELEASE EQUAL TO OR GREATER THAN THE 0.05 GPH STANDARD. <br />INTEGRITY TANK TESTIING��E'RV)ICES, 166 FRANK WEST CIRCLE, STOCKTON, CA., 9)5206, (209) 466-8036 or (800) 262-8318 <br />CERTIFIED TESTER /V C" ""�0 STATE LICENSE 0 TEST DATE J <br />