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416 2nd <br />t CA <br />32 <br />AFF®R®A®TE T (209) 744-0112 (2 9)1744 0116 FAX Tes R port <br />fest Report <br />TEST DOE Z -I <br />SITE NAME -V S�&1/,r� PHONE (Zpj I �6f Z7 <br />ADDRESS C4 ZO Ya A-,"OAAA^ i d .. _ <br />'i rA fs2 YD <br />tj <br />Test Method TV. <br />Test Equipment Used: <br />IdentifySpill Bucket (By Tank r1 - <br />Number, Stored product, etc. <br />Bucket Installation Type: $ <br />Bucket Diameter: <br />Bucket Depth: <br />Wait time between applying <br />vacuum/watei and start of test: <br />Test Start Time fir): <br />` Initial Reading TM <br />Test End Time (Tp): <br />Final Reading (Rp): <br />Test Duration (Tp - Tt): <br />Change in Reading (RF - R�: <br />Pass/Fail Threshold or <br />Criteria: <br />Cornment.9 (inclu ,. infra »rnNn <br />rostatic ❑ Vacuum <br />�//^MSOtr(vyG HzZ <br />S / 2 / <br />A Bury B Birect Bi <br />ained in S ❑ Containe <br />I 13 <br />I <br />made prior to <br />/ Not Present <br />❑ Other <br />Equipment Resolution <br />3 <br />f3 Bireet BuryHaest <br />my <br />❑ Contained in St <br />❑ Contain. <br />d in S <br />/ / <br />l/ <br />13' <br />/2' <br />l 1 <br />p <br />l/// <br />Z <br />IZ <br />o <br />/� <br />/0p <br />Imo- <br />Ii <br />Lo <br />Test Water: Taken with tester Lefton site <br />:by certify that all the information contained in this report is true, <br />`ate, and in full compliance with legal requirements. <br />^ t Technician: " L2 1 -UT r/1 T ICC #: __5_2491 15 -UT <br />OTTL #: 97-1143 <br />