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aion � <br />Precision s Testing <br />License No. 73848 <br />DATA CHART FOR TANK SYSTEM TIGHTNESS TEST <br />T* <br />PLEASE PAIN <br />1. OWNER Property ❑ <br />Name <br />Tank(s) <br />Neme <br />7--11 # 14117 2725 COUNTRY C <br />2. OPERATOR Name Atldreaa z P <br />3. REASON FOR REGULATION GOVERNING II11DERGROUND <br />TEST CHAPTER 16 CRAFTER 3 TITLE <br />(Explain Fully) CODE <br />4. WHO REQUESTED <br />TEST AND WHEN Name <br />Address Z,p .,e,,,._a•.,_,.,. <br />Z p Representative Telephone <br />Address <br />Title <br />LVD. STOCKTON CA.Lir <br />Telephone <br />GE OF HA2AR SUBSTA <br />i.omPany err niiiimuv,i -- <br />Address <br />4p <br />Capacity <br />Brand/Supplier <br />Grade <br />Approx. Age <br />Steeufiberglass <br />Identify by Direction <br />5, TANK INVOLVED <br />NORTH SOUTH <br />10,000 <br />BE E <br />UNLEADED <br />STEEL <br />NORTH SOUTH10,000 <br />TANK <br />MID GRADE. <br />STEEL <br />Use additional lines <br />NORTH SOUTH <br />10,000 <br />LINES <br />PREMIUM <br />for manifolded tanks <br />- <br />carver <br />Fills <br />Vents <br />Sipnones <br />Pumps <br />Location <br />6. INSTALLATION <br />FRONT <br />CONCRETE <br />4" <br />2 I <br />RED <br />DATA <br />JACKET <br />- <br />OF <br />S jdoOnfi i Ede driveway. <br />Concrete. Black Top. <br />Sae, Tuefill make. Drop <br />tubes. Remote Fills <br />Size. Manifolded <br />Which tanks' <br />Make rt known <br />Rear at station, etc. <br />Earth. etc. <br />Is the water over the tank? <br />7. UNDERGROUND <br />BELOW <br />TANKS / WELL PIONT <br />❑Yes KINo <br />WATER <br />Depth to the water table from <br />grade <br />8. FILL -UP <br />ARRANGEMENTS <br />9. CONTRACTOR, <br />MECHANICS, <br />any other contractor <br />involved <br />10. OTHER <br />INFORMATION <br />OR REMARKS <br />11. TEST METHOD <br />Tanks to be filled _1_9__SLMr. 5 z 1 1 / 9 2/ 2 Date Arranged by Name Telephone <br />Extra product to 'lop otr and run tank tester. Haw and who to provide? Consider NO Lead. <br />TESTING CO. <br />Terminal or other contact BENETO TANK LINES WEST SACRAMENTO —U—LI F <br />for notice or inquiry Company Name Telephone <br />SELF LEVELING STANDPIPE AND DTS. 2,000 <br />Additional information on any items above. Officials or others to be advised when testing is in progress or completed- Visitors or observers present during test. etc.. <br />❑ PETRO TITE # 2 ❑ PETRO Q,OMP ❑QUICK CHECK 2000 <br />Tests were made on the above tank systems In accordance with tell procedures prescribed for <br />11a. TEST RESULTS as detalted on attached test charts with results as loilows: <br />Tank Identification <br />Tight Nei Volume Charge Par Hour Date Tested <br />�UNLEADED YES _ <br />5/12/9 2 <br />D GRADE +.022 5 1g 92 <br />PREMIUM YES _ 5/12/92 <br />12. SENSOR <br />CERTIFICATION <br />1/23/92 <br />Date <br />418 <br />$anal No. of Thermal <br />Sensor <br />Technicians NI <br />W. CAMPBELL CHAMPION'S PRECISON TANK TESTING <br />t 92-1324 P.O. BOX 13059 SACRAMENTO CALIF. <br />Certification I <br />916--927-1557 1-800-660--9443 CALIF. <br />z <br />AL - <br />z SACRAMENTO 1-800-949-9443 NEV_ <br />Certification a <br />