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ITO <br /> Sacramento Equipment Maintenance Company `Ii <br /> 2533 Connie Drive N O V 1 1 1990 Calif.Conte. License 1502377 <br /> Sacramento, CA 95815 ENVIRONMENTAL HEALTW # 69141 <br /> PLEASE PRN2716 Data Chart for Tank Syst§ ig"ffl11AM Test Station A' <br /> 1. OWNER Property❑ OILPLEASAMT 7=73W <br /> Tankm❑ E R.waewewir T, <br /> Name AOOrw 1lepreaantstM T,leded, <br /> 2. OPERATOR <br /> Hama Address <br /> 3. REASON FOR <br /> TEST <br /> (Explain Fulm If <br /> 4. WHO REQUESTED <br /> TEST AND WHEN Nam° 5- TMle camwroorAffiliation ate <br /> Address Telephone <br /> Identify by Dtrectlnn Capacity Brand/supplier Orad, Approa.Age BIWIRhrplar <br /> 5. TANK INVOLVED t R r <br /> Lr �Yn <br /> Less additional lines <br /> tank L <br /> for manlldd,d tank, <br /> toration Co"', Fills vents Siphoiee pumps <br /> 6. INSTALLATION <br /> or <br /> DATA $ cTGG <br /> 4k-eGSyCa!x p� iVp TC�/r�S?P <br /> NoM Yid,drNeevay. Concrete.Black Top. Sae.Tlleas make.Drop suction.Remde, <br /> Beer W,Mion,etc. Earth.mC IvIi".Ramote Fee $&a,Mannolow Which tank°? Mak,s known <br /> 7. UNDERGROUND Is Met wetn OwFr�lAit' lake <br /> WATER Dept b ae water YWe 6 /4>V/ Fd r.jr ❑rr K No <br /> 8. FILL-UP Tania Y as ftd hr' Date Arranged <br /> Name Telephone <br /> ARRANGEMENTS Fisc tecta b by Or and rvn Ynk voterHave,and who b WOVIMT Orwin N0 land. <br /> Terminal or saw Contact <br /> 1.notice W Inaulty <br /> Company Nae - Teledona <br /> 9. CONTRACTOR, (- <br /> MECHANICS, i <br /> bey other contractor <br /> Involved <br /> 10. OTHER <br /> INFORMATION <br /> OR REMARKS <br /> AddkbW Ytometion On my lima above.OMCIYI Or Ohm b h adNrd ween Weft Is In Planes W oompletW.vbaore or olsome rs erre during we.ate. <br /> 11. TEST RESULTS Tests were made on the above tank systems In accordance with test procedures prescribed for <br /> as detailed on attached test charts with mill as follows: <br /> Tera knakabn Ttph taskepe IndWtsd Date Tested <br /> e)JI 91A <br /> R f <br /> C)Akrojo <br /> s <br /> 12. SENSOR 13.This Is to certify that thane tank systema were tested on the date(s)shown.Those Indicated as"Tight"meet the criteria established by <br /> CERTIFICATION the National Fire Protection Association Pamphlet 329. <br /> Te M <br /> It a the responsibility title owner and/in operator of this system to immediately advlse stale and knul euagrbies of my <br /> Dre ^ implied lizardd th <br /> ane possibility of my reponeble pollution m mim <br /> the enment as a resd ua to indicated failure of this <br /> "am.Heat Consultsnts Incorporated and lor SACRAMENTO EWIPMENT MAINTENANCE COMPANY,INC.does not <br /> 1y aswme any nespowidlly W liability for any Ion of product to the environment. <br /> serial N0.01 Thermal Cresoatln a f� <br /> B,elaOl <br /> Data oYirra Tank OwnerlOwretor�`,�Q � Date <br />