Laserfiche WebLink
11 <br />AFFORDA-TE$T <br />416 2nd Street Gait CA 95632 <br />Spill <br />Bucket <br />Identify Spill Bucket (By Tank ' 1 <br />Number, Stored Pro Die <br />(209) 744-0112 (209) 744-01 16 FAX <br />Test <br />Report <br />W Direct Bury 0 Direct Bury <br />0 Contained in Sump 0 Contained in Sump <br />11 Direct Bury <br />0 Contained in Sump <br />Bucket Diameter: <br />I <br />TEST DATE <br />Bucket Depth: <br />Wait time between applying <br />and start of test: <br />ADDRESS 1' 7 <br />CONTACT: <br />-Vacuum/water <br />Test Start Time (Ti): k 1�D (D C:> <br />0 Z)o <br />Initial Reading (Rj): 7- Z <br />Inspector. Z11 -1a <br />rese,nt 21 <br />Not Prese <br />3. SPELL BUCKET TESTING INFORMATION <br />Test Method Used: P(Hydrostatic 0 Vacuum 0 Other <br />Test Equipment Used: --F4+ i-, re 1J., C5 Equipment Resolution: <br />Identify Spill Bucket (By Tank ' 1 <br />Number, Stored Pro Die <br />.3 <br />4 <br />Bucket Installation Type: J@ Direct Bury <br />0 Contained in Sump <br />W Direct Bury 0 Direct Bury <br />0 Contained in Sump 0 Contained in Sump <br />11 Direct Bury <br />0 Contained in Sump <br />Bucket Diameter: <br />I <br />Bucket Depth: <br />Wait time between applying <br />and start of test: <br />-Vacuum/water <br />Test Start Time (Ti): k 1�D (D C:> <br />0 Z)o <br />Initial Reading (Rj): 7- Z <br />Test Duration (TF; — Tj): <br />t4 12 <br />Change in Reading (RF - Rj): <br />Pass/Fail Threshold or <br />Criteria: J <br />,Comments (include information on repairs made prior io tesiting, and recommendedfollow-upforfai ed tes s) <br />� <br />� <br />` <br />� <br />` <br />Test Water: 2]Taken with tester E]Left on site <br />| hereby certify that all the information contained inthis report iotrue, <br />accurate, and in full compliance with legal requirements. Technician- <br />Signature: <br />aohnioian- <br />ICC #: <br />8'notuna: <br />Zane A. Nimmo <br />5263322 -UT <br />