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F <br /> [AFF0R,DA,-TE$? <br /> Report <br /> 416 2nd Street Galt CA 95632 ill Bucket <br /> (209) 744-0112 (209) 744-0116 FAX <br /> fest <br /> TEST DATE,—) 1[,j 2 <br /> SITE NAME <br /> PHONE ( <br /> ADDRESS '�DD ` <br /> CONTACT: <br /> Inspector: ' i <br /> .f Present / Not Present <br /> 3. SPILL BUCKET TESTING INFORMATION <br /> Test Method Used: Hydrostatic ❑Vacuum <br /> Test Equipment Used: ___ ❑Other <br /> `TAPE" ?'0 Equipment Resolution: `fib <br /> Identify Spill Bucket(By Tank 1 <br /> Number,Stored Product, etc. DT 2 3 4 <br /> Bucket Installation Type: XDirect Bury ,5Direct Bury ❑Direct B <br /> ❑Contained in Su ❑Contained in S urY El Direct Bury <br /> Bucket Diameter: ❑Contained in Su ❑Contained in Su <br /> Bucket Depth: 2 'Z <br /> Wait time between applying PP ying i 1) <br /> vacuum/water and start of test: IV <br /> Test Start Time(TI): l 32 i 3 <br /> Initial Reading(RI): , <br /> Test End Time(TF): l q Z 0 14 <br /> Final Reading(RF): � t <br /> Test Duration(TF—TI): a ;,,, <br /> 4" ` ' ? 0 v <br /> Change in Reading(RF-RI): <br /> Pass/Fail Threshold or <br /> Criteria: — - <br /> Comments -(include info° atioh o airs made prio`i t <br /> d recommended follow-up for failed tests). <br /> Test Water: Taken 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. <br /> Technician:' Lyle D. Nimmo <br /> Signature: ICC#: 5249115-11T <br /> / OTT #: 97-1143 <br />