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FA <br /> ® /� •ter. _ <br /> ������'� � 416 2nd Street Galt CA 95632 Spill BUCket <br /> (209) 744-0112 (20'9) 744-0116 FAX Test Report <br /> TEST DATE <br /> SITE NAME Rt O)P�— L._13t ti <br /> t ut PHONE ( �i <br /> ADDRESS <br /> 6 j) ' waw CONTACT: Rt L <br /> Inspector: i Present 1 Not Present <br /> `.J <br /> 3. SPILL BUCKS_ T TESTING INFORMATION <br /> Test Method Used: 0 hydrostatic a Vacuum ❑Other <br /> Test Equipment Used: Equipment Resolution: <br /> Identify Spill Bucket(�y Tank 1 _ 4 <br /> Number, Stored Product, etc.) �3irect BuEE2 <br /> irect BBucket Installation Type: ury ❑Direct Bury ❑DirectBury <br /> ❑Contained ontained in S 0 Contained in S ❑Contained in S <br /> np <br /> Bucket Diameter: <br /> Bucket Depth: <br /> Wait time between applying <br /> vacuumlwater and start of test: <br /> Test Start Time(TO: <br /> Initial Reading(Ra): ►-tt <br /> Test End Time(TF): <br /> Final Reading(RF): _e h <br /> Test Duration(TF—Tj): �. <br /> Change in Reading(RF-Rj): �. <br /> Pass/Fail Threshold or <br /> Criteria: <br /> p r a c r R ,.,s ill ] " IRS a3 r I' S Lf"`FI i <br /> � 5 All �Q � 5 a� u. f 5 .. <br /> Comments — (include in orinatioo ©n re airs made prior t <br /> �if P P g, and recommended follow-up for failed tests) <br /> Test Water: Taken with tester Ef Left on site <br /> I hereby certify that all the information contained in this report is true, <br /> accurate„ and in full compliance with legal requirements. Technician: Lyle D. Nimmo <br /> �/ ICC#: 5249115-UT <br /> Signature: _ OTTL 1#: 97-1143 <br /> r^s: V <br />