|
R
<br />a
<br />...a..� sw:aawrti.a.«tm�a;.. �:.des'..'.. .m.«rar...ar:m:w....�.:..�. --.,...�:...:...,.�p...,..,,,,..•.,s,...a,,,:..,:u:...s�..:.v..:..,...o.....,�.�r.....:.,�.'......,.:«,..b..»„..,...-...a"�.w:,w°.,'.m�...«.
<br />7
<br />Data Chart for Tank System Tightness
<br />PLEASE PRINT K TESTER
<br />1. OWNER THE CUSTOMER_ COMPANY 0157Park Rd.. Benicia 707-745-6691
<br />Name -- Add T
<br />Tank(a)
<br />Name Address
<br />` Tu
<br />2. OPERATOR !
<br />w ”
<br />3. REASON FOR
<br />TEST
<br />(Explain Fully) —
<br />4• WHO REQUESTER STOKER
<br />TEST AND WHEN flame rise
<br />. base
<br />TSI , Ona
<br />S• WHO IS PAYING CUST0I1ER a e
<br />FOR THIS TEST? Commeny, Aoency at Irdlviduat Person Au
<br />WtBlln® Address city5.....
<br />Attention of. Order Ne. F3°her rnstmetimns
<br />Identify by Direction Capacity Rr !S a t iib
<br />6. TANK(S) INVOLVED
<br />Location Cover Fido Vents Siphons Pumps
<br />7. INSTALLATION
<br />DATA -e Alt 211
<br />Kenn Inside d0voway, Concrete, Steak Tom, Site. TA4111 make, brow Suction. timate.
<br />Weer of station., ett. Eann, etc. , r . ,.,tubes, Asmale Flits , Sits, AMonifotdod Which tanks? Make it knowft
<br />3. UNDERGROUND M - �. Is the water overetre tank t
<br />WATER Depth to the Water table -- Yes, No
<br />Tanks to be filledhr. Date Aftenifed by
<br />. FILL-UP Name Totoo
<br />ARRANGEMENTS Extra product to "top off" and tun TSTT. Now and who to previdet 7 Consider NO Lead.
<br />Terminal or other contact
<br />for notice or inquiry
<br />born y N Tmfamtio
<br />10. CONTRACTOR,
<br />MECHANICS.
<br />any other contractor
<br />Involved
<br />11. OTHER
<br />INFORMATION
<br />OR REMARKS
<br />Additional inform ` n on env et . ;off' a of others to be advised when tatiting is in piagrealt at conertated, Vtsrtota oro nt
<br />during test etc.
<br />Tests were made on the above tank systems in acmdarice with tea procedures p ll
<br />12. TEST RESULTS i lts as follows-
<br />Tank Identification Tight I L Indicatad Bate Tested
<br />-- IaPi 1 s -
<br />This Is to certify that these tmk systema were tested on the d s) shown. Those Indicated ••Tbghtr• most the cAteds established by
<br />13. CERTIFICATION the N _Fire Protection A P
<br />—
<br />THE CUSTOMER COMPANY
<br />� r � Tss4irry ntraetmr mr COmmsnY• y: rsatura
<br />5 a k Rd. Benicia Ca. 94510
<br />Serial No. of Th Tsahnimians
<br />m
<br />e
<br />X,
<br />r `~fi
<br />ikYt'�'b�##�",t°+. • ..,�xL +.ai}`I"! , � n r 4 , ^,: r-.? , '�• 4"rt � x - �'e'a..cya�s.am:+*aemrre�bn•Tsv«tar,m�ra�saaeweM.i.• vna.,i � .?, ...�:i., w .. . � � , Y r ..
<br />
|