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0 0 <br />���®®®�®�� -p- <br />1 C A <br />416 2nd Street <br />(209) 744-0112 <br />Galt CA 95632 <br />(209) 744-0116 FAx <br />Spill BUcket <br />rest Report <br />TEST DATE <br />SITE NAME 0, Jj, r <br />ADDRESS 1 <br />PHONE (-;? <br />CONTACT: 1 h v[ <br />r! i vi eI % <br />❑Direct Bury45Vdct Bury <br />RfZ rained in Sump D Contained in Sump <br />Inspector: 0 <br />resent / Not Present <br />3. SPILL BUCKFTTF,RTTNC iNWOVMATMV <br />Test Method Used: Hydrostatic D Vacuum D Other <br />Test Equipment Used: r a ,p p Equipment Resolution: <br />Identify Spill Bucket (By Tank <br />Number, Stored Product, etc. <br />12 <br />14 <br />4 <br />3 <br />/ <br />Bucket Installation Type: <br />❑ Direct B ' <br />P4ontained in Sump <br />❑Direct Bury45Vdct Bury <br />RfZ rained in Sump D Contained in Sump <br />❑ Duect Bury <br />D Contained in S ump <br />Bucket Diameter: <br />i <br />Bucket Depth: <br />Wait time between applying <br />vacuum/water and start of test: <br />Test Start Time (TI): <br />8 55 <br />5 S ) <br />Initial Reading (Rj): <br />`1 z <br />1 I 1 <br />Test End Time (TF): <br />9 CY5 <br />,5 (�, <br />Final Reading (RF): <br />9 l y <br />10 1 I <br />Test Duration (TF - TO: <br />h Dv f <br />J J.% <br />Change in Reading (RF -R): <br />Pass/Fail Threshold or <br />Criteria: <br />aRN <br />-- <br />I&I <br />UOMMCnTs - (include information on repairs made prior -to testing and recommender follow-up jorfailed tests) <br />Test Water: (Taken with tester Left on site <br />hereby certify that all the information contained in this report is true, <br />ccurate, and in full compliance with legal requirements. <br />Technician:' Lyle D. Nimmo <br />ICC #: 5249115 -UT <br />OTTL #: 97-1143 <br />