Laserfiche WebLink
Data Chart for Tank System Tightness Test <br /> SL rftlNT �CtH!AMFIp *S:D RECIS.I'ON TANK <br /> OWNER rm""y ❑ AMTIRTCAN SAVINGS, od, I Ftf RrfefntaTtw rataRhOne <br /> Ten►{.� [] ATTN: Transportation De t. Vic <br /> ".m. Addrnt h+Prfasn Y.U» iNfpnaM <br /> OPERATOR � �N r'i ,�. r / r t I r Y S r 10.11 . <br /> "►ms Adorftr CeleOhens <br /> REASON FOR REGUAMN GOVERNING UNDERGROUND STORAGE OF HAZARDOUS SUBSTANCES <br /> TEST SUBC11APTER 16 OF CHPATER 3 OF TITLE 23 OF THE CALIFORNIA ADMINISTRATIVE CODE <br /> (Explain Fully) - <br /> OWNER <br /> YYHO REQUESTED cortroanr or Andtaoon Diw <br /> TEST AND WHEN Trur <br /> Ado+n, 1H.RhOns <br /> WHO IS PAYINGTfleondne <br /> FOR THIS TEST? Com" Agency or Ind rrdva Parton Aulno'rt-nq Tnle <br /> ailhnq Add+sst C'lr Slats Zip <br /> AlHnlron or: - Orde.No Othrl InetrVtlydnt <br /> Identity by Dtreeiwn Capacity Stand/SVpphei Grade Appwoa.Aye SMI/Fibarglaas <br /> TANK(S) INVOLVED oV=ow S2&t nej `f A or',, <br /> T `� <br /> Location Cover Fd1, Vinic Siphons$ Pumps <br /> INSTALLATION a t pofp d+�flFT <br /> F04/171 <br /> DATA F�•OwaT el re rZ, ..,_• "►uR rir rJ <br /> NuAt.rna+ds ehrewsy. Conerstt.Glick too. Sirs.Trtstrll mese.0100 � Mw <br /> Rsar of sgtion.sic t.rrh,at, tubs,,n.mcle Fiat Sore.M.ndoldsd which tanks l Maho*►s it knoownn <br /> UNDERGROUND is the water over the lank t <br /> WATER Depth to the Wolof table Yes <br /> ❑ Yes ❑ No <br /> Tanks to be filled hi �I G~ Dale Anangad by � 4 ' <br /> aa <br /> FILL-UP v• atna Telephone <br /> ARRANGEMENTS Extra product to 10P all"and run TSTT How and who to provide F Consider NO Lead, <br /> Terminal or other contact <br /> for notice or IngVlry - Narnf retsPnons <br /> C omOt^t <br /> CONTRACTOR, — — - <br /> MECHANICS. — <br /> any other COMractot <br /> involved <br /> OTHER <br /> INFORMATIONOR REMARKS —�.__---- <br /> Add,nonairnfo­at,bn o^ am sir-'% ann„r Uhc'nls o• n'"r•$to be ad.•,ed whrn to Fhnq e1 rn propoess or compleled Vrutott or ob3ervats pre Tenl <br /> d.—op irtl art ! <br /> Testa were made on the above lank systems In accordance with lest proceoures preecrlbed rot PETRO=TITS <br /> TEST RESULTS as detailed on anache•d test chins with results as follows: <br /> ' <br /> iank I Lea►mgr Indicated w Date Tested <br /> This is Id certify that these tank systems ware tested on the data(s)shown,Those Indicated of"Tight"'maN Itte criteria estaWltshed by <br /> CERTIFICATION the National Fire Protection Asociation Pamphlet 779. <br /> CVAMPION"S PRECISION TANK TESTING <br /> Du. ----- L JV S HARVARD" �nnlrr a Br Sq n.v� <br /> PB <br /> �:R TO15 <br /> SralNo Tn.+•nal ..�-._�..�..._..r.r nh�r.��:��..-_...._.._. 800 <br /> ectF7[7i�-7y`+.J Ado„st <br />