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� (2416 2nd Street Galt CA 95632 Spill Bucket <br />AFFOR I DA-TE$T 1 09) 744-0112 (209) 744-0116 FAX; Test Report <br />TEST DATE: <br />SITE NAME rj1,OVWA1 *V-zpfw , PHONE( Zo <br />ADDRESS /4/ <br />,4 CONTACT: <br />In <br />Present l/ Not Present <br />Bucket Diameter: <br />3 SPIELL BUCKET TESTING INFORMATION <br />Test Me:thod Used: <br />' <br />ydrpstatic <br />0 Vacuum <br />0 Othe <br />t: <br />Test Equipment Used: ;ae <br />: <br />pIden;tify <br />~Test Start Time (Tj): <br />� <br />Equipment ResolutiZ.�, <br />ntj Spill Bucket (By Tank <br />Number, StoredProduct, etc) <br />1 <br />� <br />3 <br />91 <br />4 <br />Bucket Installation Type: <br />0 Direct Bury <br />JWContained in Sump <br />0 Direct Bury <br />If Contained in Surn <br />0 Direct Bury <br />Of Contained in Sump <br />11 Direct Bury <br />. 11 Contained in <br />Bucket Diameter: <br />12- <br />1 z <br />17 - <br />Bucket Depth: <br />Wait time between applying <br />vacuum/water and start of test: <br />4 <br />~Test Start Time (Tj): <br />� <br />I 7-5o <br />� <br />x <br />Test Duration (TF - Tj): <br />rz <br />PizChange <br />in Reading (RF - Rj):Pass/Fail <br />Threshold orComments <br />- (include infonnation on' rqpairs made prior "toesting, and Mrecommen&�fbllow-up <br />for failed <br />Test ....VV81e[ |�� �� |T@keOVVit�� �f��f�[ | |LeftOOSit8 �= <br />| hereby certify that all the information contained in this report is true, <br />accurate, andin, full, compUace ithlegal requirements. Technician -- <br />ICC #: <br />eohnioion-.|CC#: <br />Signature: <br />_ <br />Zane A. Nimmo <br />