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AFFORDA-TE$T I(209) 744-0112 (2 9)1744 0116 FA <br />416 2nd <br />Spill Bucket <br />Test Report <br />TEST DATE `l : 19 -6 <br />SITE NAME y/�} -~ — PHONE <br />ADDRESS CONTACT' <br />qF,2(-)(.1 , <br />Inspector: P t� lr�' an w K) (Present Not Present <br />3. SPJI..L BUCKET TESTING, INFORMATION <br />17- <br />Inspector: <br />z <br />Test Method Used: (Hydros a(ic U Vacuum ❑ Other <br />Test Equipment Used: — Q(�. z Q Equipment Resolution: L <br />Identify Spill Bucket (73y Yank 1 2 .3 4 <br />Number, Stored Producr, etc. IE'SE-L--- <br />Bucket lnstallntioii'1'ype: <br />ADL-ect Tlnry <br />❑ Direct BUY <br />❑ Direct Bury <br />❑ Direct Bury <br />U .ontained in Surnp <br />U Contained in Sun)) <br />❑ Contained in Sum i <br />❑ Contained in Sump_ <br />w �^ <br />Bucket Diameter: <br />I t <br />Bucket Depth: <br />Z <br />- <br />Wait tune between applying <br />valCuurll/water and stat't of test: <br />_ <br />- <br />Test Start Time (T,): <br />Initial Keading (Rr): <br />L) <br />�. <br />Test End Time (Tr): <br />I%incl Keading (Rt): <br />I v �� <br />- % <br />Test Duration (Tr Tr): <br />Change in Reading (Rr-Ri): <br />_ <br />Pass/hail Threshold or <br />Criteria. <br />{yt <br />AN <br />ya <br />.Comments - (include infurmatioit on repairs made prior to testing, and recon:mcncle.d follow-up for fcril(td tavis) <br />Test Water: Taken with tester D Lefton site <br />I hereby certify that alf the information contained in this report is true, <br />accurate, and in full compliance with legal requirements. Technician:, Zane A. Nimmo <br />)CC*: 5263322 -UT <br />Signature: —-----_-_._ )BTTL#: 04-1676 <br />Looln Xvd TT:ZT 8002/CT/OT <br />