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416 2nd Street Galt CA 95632 1Bucket <br /> AFFORDA® (209) 744-0112 (209) 744-0116 FAX Test Report <br /> TEST DATE / f" <br /> SITE NAME 1410 S r�'b PHONE ( &q <br /> ADDRESS LA-rvOZ6 P CONTACT: <br /> Inspector: 61e Present_�) / Not Present <br /> 3. SPILL BUCKET TESTING INFORMATION <br /> Test Method Used: Hydrostatic D Vacuum D Other <br /> Test Equipment Used: Equipment Resolution: < ( b " <br /> Identify Spill Bucket(By Tank 1 2 ` 3 'D A6 4 <br /> Number, Stored Product, etc. <br /> Bucket Installation Type: Direct BuryDirect Bury Direct Bury D Direct Bury <br /> D Contained in Sump D Contained in Sump D Contained in Sump D Contained in Sump <br /> Bucket Diameter: 'Z f Z 12- <br /> Bucket <br /> 2,.Bucket Depth: <br /> Wait time between applying <br /> vacuum/water and start of test: <br /> Test Start Time(Ti): 915 915 <br /> Initial Reading(RI): -7 'A_ i v 'Y, <br /> Test End Time(TF): lots, lot's <br /> f ea i <br /> Final Reading(RF): 16— <br /> Test Duration(TF—TI): Q- <br /> Change in Reading(RF-Rj): -- <br /> Pass/Fail Threshold or _ <br /> Criteria: <br /> COmments-(include information on repairs made prior to testing, and recommended follow-up for failed tests). <br /> Test Water: Taken with tester [:]Lefton site <br /> I hereby certify that all the information contained in this report is true, <br /> accurate, and in full compliancewith legal requirements. Technician: , Zane A. Nirnrno <br /> ICC 5263322- T <br /> Signature: "� OTTL#: 04-1676 <br />