Laserfiche WebLink
Sep 29 02 03: 44p Elit Contractors Inc 209461 p. 7 <br /> SWRCB,.luttuaYt'y 20W <br /> 9. Spill Bucket Testing Report Form <br /> 7'hcs form rs intended for use by contractors perfrirming amoral testier&of USTspi11 c»ntaixprent savawt-s.The completed form and <br /> printouts fi»rn tests(if A pphcaNe),should be twovided to the facility m~r1gWratmr for suhmitild to the local re),ulatmy agency. <br /> 1, FACILITY INFORMATION <br /> FacdityNarne: FLYING J 0500075 08/01/7008 <br /> Facility Address; 1501 N. JACK TONE RD RIPON, CA, 95366 <br /> FacilityC:Ontxt :JOSE Phonc; (209) 599-4141 <br /> t?atc Local Agency Was Notifwd of Tc%"g <br /> Name oflmcal Agcmy to pector(ifpn:scnt during tou-S6 9). <br /> 2. TESTING CONTRACTOR INFORMATION <br /> Company Name: TAaNKNOLOGY. INC. <br /> Tochnician Conducting Teat.: JARROD COOKE <br /> Crcdentialst:FICSL8 Conuac4or11 TCC Service Tech. ❑SWIRCIR Tank Tester M Other/SP:cify)a <br /> liccnsc Ntunber: 743160 <br /> 3. SPILL BUCKET TESTING INFORMATION <br /> 'rewt Method Used- t " t Hydrustatic Vacuum ® Othcr <br /> Test E.guipment Used:v`p1L EgwymeAt kcsolulion:vP1t to gph <br /> ldmtify Spill Buc3 aVBy Taak t x DIP PILL a 2 DZi; el'LG - ] 1 a.a ViLL <br /> Xwmher.Stored Product.ek:) <br /> Q Pircct Bury ®Ducie.Rury ®Direct Bury Q Dircct Bury <br /> t3uckctln,tattation Type: <br /> Contained in 5 ❑C.ontuimxl in S ❑COnrrinctl in$umry ❑C.cettminctl in Sump <br /> Bucket t tiian,cter. <br /> Ruckct Depth: 16- 16" 16" <br /> Wait tient,between applying Smin. Stain i1Rlt1 <br /> vacuum/wwwr atnd starting aryl: <br /> TcstStart Time(Tt ?: 12:05 12:7.2 17:08 <br /> Initis)Rcading(RI )= 5-372 9.784 S.114 <br /> Test End Time(TF): 12;20 12:27 12:23 <br /> final RcadingRr 5.286 9.943 5.114- <br /> Tcst Dov ition: --Sorin 15min 15min <br /> Chart in Rcid (12 F-RI ). .01gph .01gph .caCgph <br /> Pft:.'Fait'l'hrcxhoid or _ sgph .059ph -05gph <br /> Criteria: <br /> Teat RmA: XPW720 X PaiaAt Fal R Pass U Fail— Li Paso Fail <br /> COMMMIS-(include information on relwirr made-prior to 14wring,and recammended,foflow-up for.failt d testy) <br /> CERTIFICATION OF TFCF"'ICiAN RESPOySMLE FOR CONDUCTING T)FI'aS TESTING <br /> 1 hereby cenA :that alt the information contained in this rgwrt ix Arae.accurate,and is fmM COMP&MCC with If9wi rcquirren R'A- <br /> Tcchnician`a;Silmaturc- „�� -� Date: 08/01/2006 <br /> Statc law:;And regulativas do not cunrady require testing to be perforated by a qualified caatractor.However,tical mvViretncnu <br /> may bl morr°A(&ingertt. <br /> L d eopm so ZZ deS <br />