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s •WORKSH FOR SUBMITTAL TO GOVERNMENTAL NCY <br /> .. ._._ _W <br /> OWNE R/OPE RATOR C rT y NJ/z T"OC�IGyt9v.J SITE ADDRESS Gc��y YAR p <br /> CITY. g r r-,c, IG env COUNTY <br /> MAILING ADDRESS <br /> SITE AGENT_ S S 5 TELEPHONE <br /> ►' <br /> ARRIVED TEST SITE0�fOC�NOURS TANK LOCATION/NU148BR-- PRODUCTrNVIRONMEN <br /> — �LrS �,� TAL HEALTH' <br /> DATE/TIME STORAGE FILLER 6' _ 4f C!PRODUCT LEVEL AT ARRIVAL �� NCHES BELOW TOP OF,FILL. NOMINAL TANK SIZE /Q,ion(D <br /> TANK MATERIAL� ��ST�g'L APPROX. AGE�2KIGRS. FILL SIZE/TYPE'= OVERFILL CONTAINMENT TYPE 4.,,OA <br /> AN GRAVITY -'_ 3. D AT -7-K DEG. F. - API GRAVITY OF;� .S B 6OF - COEFFICIENT OF EXPANSION OF: _00 x 9_72 5- COE of 4 14 Z <br /> VISABLE VENTING APPEARS TO BE AT: FILL END, FILL OPPOSITE END, HAS BURP TUBB,® HAS A BALL CHECK. OTHER W11 b JAZ C,F T%FNIL <br /> VISABLE VAPOR TRAPS TO BE BLED: BALL CHECKS, MANWAYS, OTHER A 1QA (� <br /> PHASE II VAPOR RECOVERY SYSTEM TYPE: BALAN ASPIRATOR ASSISTED LONG RUN WELLS MANIFOLDED NONE OTHER <br /> PUMPING SYSTEM:QTI TURBINE MAKE_ CCAS i_ O'/ MODEL S 3 00 A G- I PIPE LINE LEAK DETECTORS Y H� <br /> CHARTED TANK SIZE+`ESTIMATED LINE QUANTITY (a RODULT ADDED TO FLOOD SYSTEM C YSTEM GALLONS TOTAL / O, 0 � <br /> AMBIENT WEATHER CONDITIONS: TEMPERATURE PRETEST2aPOST TEST—JE6 RAINING CLOUDY WINDY NIGHT OTHER <br /> SYSTEM FLOODED 30 HOURS .4 PSI DROP L1•5 HOURS PSI TO BE MAINTAINED ON TANK BOTTOM DURING TEST PERIOD S '/ <br /> A. GRADE TO TANK BOTTOM <br /> ' B. GRADE TO TANK TOP 5-7 '12. <br /> i <br /> C. TANK DIAMETER c <br /> 6.Pi9AE <br /> -�•• D. TEST LEVEL ABOVE GRADE 2 Z <br /> E. EXTERNAL, C TD NATER ABOVE TANK <br /> F / BOTTOM11.13 IM. X .0361 PSI . <br /> P. TOP OF FILL TO PROD. AT ARRIVAL �) N <br /> G. TOP OF FILL TO TOP OF TANK L4 <br /> H. TFZr fBVEL'TD'BOTTOM'OR TANK 5 <br /> SY2 <br /> �A!� <br /> PSI PER INCH OF PRODUCT ► 15L ` 03 I <br /> - <br /> TEST HEIGHT PRESSURE FORMULA <br /> K n I - X <br /> G _ _ 5,42- <br /> H. PSI B. PSI NET PSI <br /> REMARKS: <br /> THE FINAL TEST PERIOD AS SHOWN ON THE ATTACHED COMPUTER GENERATED DATA REFLECTS A <br /> 4 LOSS /�: .p33GALLONS PER HOUR, WITH A 99% CONFIDENCE LEVEL OF +/_ . 001 GPH. <br /> USING THE KORNER EZY CHEK II METHOD OF TESTING THE RESULTS AS SHOWN ARE�y�J/ <br /> NOT WITHIN THE STATE OF CALIFORNIA AND THE NFPA 329 GUIDELINES 0��'=M XIMUM LOSS OR <br /> GAIN OF .05 GALLONS PER HOUR FOR AcTM__r_ Y`S`PE1q TO BE CONSIDERED <br /> INTEGRITY TANK TESTING SYSTEMS, INC. 166 FRANK WEST CR. <br /> STOCKTON, CA 95206 (209) 466-8036 or (800) 262-8378 <br /> CERTIFIED TESTER TEST DATE — ? <br />