Laserfiche WebLink
Orracer Research Corporation <br />Site <br />Information / t LeakDetection <br />[I <br />Submit Completed •.: With Job! <br />Technicjan­j.,,,�. b 13-+003� #—.!:L , Date**-(-- <br />_ • <br />Site <br />t - .A1C '\;. L,. .y 22 :. <br />1!uryose of te3tt (Product on water table?in ] 000'— of weD Untestable secondary containment? Regulatory directive? New Installation? Emergency <br />Generator? Consultant recommendation? other): <br />QMA (regulatory region): /C-, L -j Ya yvq .- A4 -L - .. pt-Sse <br />Swill Bucket Test, TKl (Pass TKI.(as ail) TKA.(as ail) TICS ass ail) TK5 (pass/Fail) TK6 (Pass/Fail) <br />hype of SUM PM= (Suction) in _�� Rejxo <br />Yet Line Probes <br />Yaaor Recovery Line Probes <br />Wipes .of Backfill <br />Chound Cover ( • ,•SraS-^; <br />Ground Cover Conditioi3 (Excellent) (Fair) (Poor) (other) <br />List All Component Taves <br />Tank (Single Wall) MEMM= (Steel) (other) <br />Lines (Single Wall) (Steel) (Fibertrench) (other) <br />Vent Lines (Double Wall) (Steel) oei er ) (other) --Z " <br />Vapor Recovery er <br />P rY ( (Double Wall) (Steel) (other) <br />Vapor Recovery (Balance) <br />Sump Construction:a-� ci fo ��'iat� (Dart) (Retrofit- bolted to riser at tank top) (Retrofit -bolted to manway) <br />Snill Bucket PlwZer Tyne <br />Qverfiill Protection 1Ae_c.C,, n � <br />Tank Fills . <br />Tank.Manifolds <br />Monitoring, Well (Locationsan deobj <br />Water in <br />Sump: <br />YES <br />/ dig <br />Depth from surface: <br />Water in <br />Line trench: <br />YES <br />! 49D <br />Depth from surface: <br />Water in <br />tank pit: <br />YES <br />/ 40 <br />Depth from surface: <br />Line Leak Detectors <br />Fibertrench descri •on: �~ <br />Composition <br />Shape (draw picture if necessary): <br />Depth to top: <br />i <br />Signature of site person verifying condition of site at end 'of installation: <br />