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0 0 <br /> 416 2nd Street Galt CA 95632 li Bucket <br /> AFFORDA® (209) 744-0112 (209) 744-0116 FAX <br /> Test Report <br /> TEST DATE +2 p <br /> SITE NAME 1 W® �I u-y"a �"oo A g- f C PHONE( 2®9 ) __38Z(o (o <br /> ADDRESS 1 �} E , L-A,7Ty-R_c�>P CONTACT: <br /> -P� 120 `333 <br /> Inspector: Present �Note <br /> 3 SPILL.BUCKET.'TESTING INFORMATION <br /> Test Method Used: XHydrqstatic ❑Vacuum ❑Other <br /> Test Equipment.Used: Equipment Resolution: t t (, -• <br /> Identify Spill Bucket(By Tank 1 2 ` .3 4 <br /> Number,Stored Product, etc. DIE <br /> Bucket Installation Type: Direct Bury Direct Bury Direct Bury ❑Direct Bury <br /> ❑Contained in Sump ❑Contained in Sump ❑Contained in Sump ❑Contained in Sump <br /> Bucket Diameter: <br /> Bucket Depth: 12 t Z 3 <br /> Wait time between applying _ <br /> vacuum/water and start of test: <br /> Test Start Time(TO: <br /> Initial Reading(R4): ( t t 1 `OSE <br /> Test End Time(TF): 3� (Z -. <br /> Final Reading(RF): ( t <br /> Test Duration(TF—TI): 14 Y r2— <br /> Change <br /> 2Change in Reading(RF-N: <br /> Pass/Fail Threshold or <br /> Criteria: <br /> Comments.-(include informa ' n on repairs made prior ttesting, and recommend ed ollow-up for failed tests). <br /> Test Water: Taken with tester ®Left on site <br /> I hereby certify that all the information contained in this report is true, <br /> accurate, and in full compli nce with legal requirements. Technician-_ Zane A. Nimmo <br /> ICC#: 5263322-UT <br /> Signature: OTTL#: 04-1676 <br />