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0 6 SWRCB, January 2(W) <br />Spill Bucket Testing Report Form <br />&VIIA"Iffrof IJY <br />UW210[ft9fl-kin- MIURIT51W mic <br />2. TESTING CONTRACTOR IN <br />3. SPILL BUCKET TESTING <br />CERTIFICATION OF TECHNICIAN RESPONSIEBLE FOR CONDUCTING THIS TESTING <br />I kere cerfify that aff the information contained in tkis report is true, accurate, and in fu c with 1egal requirements. <br />Technician's Signature: ht,01 Date: <br />State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements <br />1-1 Va-c�uun--n Other <br />Test Equipment Used: MTS Mag Probe w/TDU Meter <br />Equipment Resolution: ool- <br />0, Bucket Installation Type: <br />it t <br />Bucket Diameter: <br />Bucket Depth: <br />Wait time between applying <br />est Time (TO, <br />I.- M-, M <br />Test End Time (TF): <br />all <br />Test Duration (TF T1): <br />Change in Reading (RF - Rj): <br />aj shold or <br />rite <br />ents — (include information on �pairs madepriar to tes*% and recomnwndedfollow-!pforfailed tests) <br />CERTIFICATION OF TECHNICIAN RESPONSIEBLE FOR CONDUCTING THIS TESTING <br />I kere cerfify that aff the information contained in tkis report is true, accurate, and in fu c with 1egal requirements. <br />Technician's Signature: ht,01 Date: <br />State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements <br />