Laserfiche WebLink
SWRCB, January 2002 Page of <br />o CPTT .T ./nVTi.RFTT,T. CYNOITA NT BOXES <br />Commenis — (include information on repaifs made prior to testing, and <br />Please direct any comments regarding this form to: <br />SWRC13 UST Program, Attn: Scott Bacon <br />1001 "1" Street, Box 944212 <br />Sacramento, CA 95814 <br />Phone: (916) 341-5873, Fax: (916) 341-5808 <br />e-mail: bacons@cwp.swrcb.ca.gov <br />t e Box # <br />i Spill Box # <br />Spill Box # Spill Box # <br />Bucket Diameter: <br />[[Spill <br />Bucket Depth: <br />L� <br />' <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: <br />Test Start Time: - <br />y <br />�% <br />4 <br />Initial Reading (110: <br />It> <br />Test End Time: <br />n7 ' 3-7 <br />Final Reading (RF): <br />U �� <br />Test Duration: <br />Change in Reading (RF-R,): <br />Pass/Fail Threshold or <br />Criteria: <br />Test Result: <br />`O_Pass ❑ Fail <br />ass ❑ Fail <br />❑ Pass ❑Fail ❑Pass ❑Fail <br />Commenis — (include information on repaifs made prior to testing, and <br />Please direct any comments regarding this form to: <br />SWRC13 UST Program, Attn: Scott Bacon <br />1001 "1" Street, Box 944212 <br />Sacramento, CA 95814 <br />Phone: (916) 341-5873, Fax: (916) 341-5808 <br />e-mail: bacons@cwp.swrcb.ca.gov <br />