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Data aha for Tank System Tightnec- Test
<br />L(ASc
<br />t'ItIMI
<br />(:Ilnrslrloz�r�r5'�-T"1:L':GI4IQN 'i'AN}s
<br />1.
<br />OWNER rroPeny
<br />_
<br />T.wkc.)
<br />N.,-. Pan,... A,n".. nt.1.,• t•H nhaw•
<br />"•,..• Ped.... w»a++•. A.,...• t•r.awe..,
<br />2.
<br />OPERATOR
<br />N•w.• i„•wwa-• .
<br />3.
<br />REASON FOR
<br />ILl:CI1_lJ.t1L4l N <�QVI•:RNI.N(; IJND1:R(;R )UNI) ST01kA(:I•: 01 IIAZAW)OUS SUBSTANCE
<br />TEST
<br />SUBC11A1''1'1:R 16 ()1.' (:IIArT R 3 01' TITI.1: 7.3 01' THE CAI I'ORNIA ADPIINISTRATIVE CODE
<br />I E. pi *,^ fully)
<br />------� -
<br />DIJNER
<br />!.
<br />WHO REQUESTED
<br />TEST AND WHEN
<br />N.wu. t.l.. - cew.e•A, a»Pn.l....eh a,+.
<br />Pdd.., Sala. heh.
<br />S.
<br />WHO IS PAYING
<br />{?W
<br />FOR THIS TESTI
<br />CO wa'wr. Pa.wc. e, lAa...n •• ...•.- ♦ rwe..r,wq ,.II. t.•. eweh.
<br />e.x.wa Paara. G+• su,. t.a
<br />f,t•wr.eA at: D,••. No o'.., 1-1,y ;..an*
<br />•
<br />Identdy by D,r•et.on
<br />eap.c.ty
<br />(l1.ndlSu0p1,e1
<br />Grade
<br />Aprwo.. AQ*
<br />-'eetlf,b•,pra.&
<br />TANK(S) INVOLVED
<br />) --cm
<br />BenamL_Q
<br />-'
<br />1
<br />1
<br />P
<br />4
<br />I
<br />Locat,on
<br />co”.
<br />f.11,
<br />Vent.
<br />S,phon.t
<br />�Vmds
<br />INSTALLATION
<br />veowr
<br />R ��
<br />DATA
<br />vxtC r-
<br />STDeC
<br />I-.41/
<br />Henn,n..d-a.+.... r.
<br />tt... of it -n ow, ale
<br />Cencalr 11,.ra tae,
<br />It in, .tt
<br />S,I•. T.r.an w.•.a D-0
<br />Luna. R._e,e r.,l,
<br />SSI•. Man.rolA•A
<br />Wn,ew t.,..t
<br />M.1• rl the—A
<br />8.
<br />UNDERGROUND
<br />to the -ilei a.'., the tank 7
<br />WATER
<br />Depth to Na Water table
<br />Tank& to he I.0:;L4 �d hr ri-1 �,-�It _ D.I. A". nu'd hr
<br />9.
<br />PILE-UP
<br />"'-" '"""'"'
<br />ARRANGEMENTS
<br />E -U. product to "top off" and .un TSTT Fin- and -Nn to P, ,d. r C:on d. , e.O lead
<br />TP_b-n n C __ -- — - - -
<br />?e.rr,.na o, othe, eant.cl {��.•'� -yam L j �/1I �' /� r. �f' H �� I , A
<br />to, nol.ee a..nau+,ry 1 J•t+' 1�'�• LJ -7.1-.:3 L'—_�1.._-_M--- 41 - -
<br />Cow.nan, N,-.» 1».•a^ohs
<br />•ti ,
<br />-
<br />10.
<br />CONTRACTOR,
<br />----
<br />MECHANICS,
<br />awy othe' mortal
<br />11.
<br />OTHER
<br />-
<br />INFORMATION
<br />_ -_- ---
<br />OR REMARKS
<br />_..._ _ -- -
<br />' �dd.l.n wai «nen�,n at.nn an any ,rr-ni .hn+. G', r..ala r:-�or�,ria to 0, an+,a.n ,..1-nplrtad t+', t•t n.t o, oo,e,•.,. m•�e nt
<br />da,.ng UtJ etc .(
<br />Tests were made an the slwvr lank fystems to ACCaffyanCe -IR, Iesl proCedures pre+Cnhrd for ]'6 '1'It0-TIT ii
<br />12.
<br />TEST RESULTS
<br />as detailed on atla[hed tell Cttafte -11h restful at 10110-2:
<br />Tint Idenld.frt-nn T.q,.f -. 1. &( alrH ... -._ _..`_. ._. ... -..—
<br />��A Ll F1S _ _ I _
<br />j1!lI .—
<br />This in to Cenity that (hese tank ay■lem• -ere testeC on the catroi shown. Those indltalyd As "light" marl the Crllaris rataDlished by
<br />13.
<br />CERTIFICATION
<br />the National Fife Protection Asoc,at,on r.mrhiet J77
<br />INl:' NPION'S PRECISION TANK TESTING
<br />' CA. s� 13-3059
<br />141
<br />`SA(:KAN1`NT0,
<br />G? � �3a� - � —
<br />t -W tr. r 1.r+.-,. .. .. ....
<br />- ... t. n,.�. .e •., __. ... _ }`r) rl. 1-I rl �r, ./l -i •.,din.
<br />
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