Laserfiche WebLink
.�..� _ ..•:,.,•�.,. >'-`.r,,�s �..�,�.:;� ._�,..�_�, v :I�:..r«r`N�,�ma+i"s�o° _ .. ^.'V*`�?.';C,�?'1+h�S`w`r1!@�Q . , <br />�t. <br />Cta Chart for Tank SystePTightness Test <br />- 1 pre -ry- /' t�� _ <br />�S_ INT STA TIN # �-L j j ATE - _ <br />F11. <br />7 <br />❑eunNownM ldeRep mo^u1M TWWw» <br />Terekti) El <br />Address Rapressna0ve Tmmitpllwn <br />2 OFE-PATOR <br />Aad ems <br />T�wm,o.» <br />3. RE,,SON FOR <br />r <br />I ICJI <br />Fully) <br />4. WHO REQUESTED <br />TEST AND WHEN <br />N.ne <br />Tde Gonpany w Ax,natgn <br />Do" <br />Addrw <br />T ateptwre <br />5. TANK INVOLVED <br />t+N W DirectionCaper <br />�� <br />r2u <br />ade <br />f <br />Brand G5-4r6. <br />Approa. Ape <br />Ste.uReeryttss <br />Use additional Mtsa ".L <br />10. mrmame101dad tanks <br />. <br />6 - INSTALLATION',' <br />.DATA <br />' <br />- <br />) <br />�Nwem�fntida may, <br />Mr cl stttiomt, eat. <br />Cow <br />cmcreN, Beack Tdp; <br />Ertl. sm <br />Rot Wets <br />OL <br />She. TMeea seta, Drop <br />tubas• Rrmtots Fdb Stze. MwOokled <br />Smpnwns <br />` i <br />Whkh lams? <br />fstmnmpe <br />lz, <br />SNt:tfwt <br />Ntka a tnoeee <br />7. UNDERGROUND <br />WATER <br />Depth to the wrr table <br />a <br />! IS to wow -« the trent? <br />e lj, iL � ❑ r« ❑ No <br />FILL -UP <br />"ARRANGEMENTS <br />Tmwb b M NOW N. �w <br />Deb; A-G&Atrf <br />- _ NO -0 <br />Ewa pm t% b'bp *ir rw n mm trtk bete`. taw rw edto loprowk%? Consider NO u.a' <br />T.upndmo <br />" <br />���... - <br />Termmmirmal or ovw cw tua <br />tom mmdaCe w Yquiry <br />. <br />Compam Nemne <br />TMsplgmte <br />ONTRACTOR, <br />MECHANICS, <br />an,, otter con. or <br />Mm.aea <br />— <br />10. OTHER <br />INFORMATION <br />OR REMARKS <br />AddkiO W inlorelrion on rN Mans above OKmeirs w othare b to adv d .nen lslne a in progr m c-MMt d. VuMon w otsrvers prearmt dud V bet, MG <br />11. TEST RESULTS <br />Tasb wtxe made on the above tank systems in acrbrdarice with test procedutas prasaftxd for <br />as detabod on attached test mart with resift as follows: <br />Tent tiliration Tight Uskape ndr ed Drs Tasted <br />1 <br />12 SENSOR <br />CERTIFICATION <br />Dre <br />sono No. of TM.nW <br />13. Thls b b cw Wy MM Mteee taut syww wn teeted on the dates) shown Those bmAceted se 'itphr "meet the crhw a odabbhod by Mw <br />Nedons+ tin ProlecMort Aseodadon Ps- WO 32lt <br />TeclrYeWs <br />SCOTT- co, <br />CanMaoon . 1 �y�j13 + �� TmrIM° 1,wma,aw w Sf�rm, <br />Ir�__ l919 giKET <br />z L Address <br />Cwrtlf4cttbn ._ i t S Z-� Z <br />PN66Z7 <br />