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<br /> A. Tank Bot. to Grade -1 Send Report to:
<br /> To
<br /> B. Tank Top to Grade 3 Client M e a
<br /> GRADE C. Tank Diameter y - Address 2-1" 1 ^' '"v Y °R
<br /> D. Test Level above grade 2 U City, State S"' L'"- `6'
<br /> e E. Depth of water in tank C phone( )rl> - 200
<br /> F G F. Depth for taking sample V I Attn: m• ( 4, 6 c,:s,c,
<br /> H G. Temp. Probe depth (connector) 3 7
<br /> A H. Test levet to Tank BOL 1 S L • �"F1Wi1s° The.. V+••r r �
<br /> w r wore
<br /> ""r9+rw s oewr sreW.a
<br /> J 1. Groundwater above tank bottom 0 by ow M . Foe P" ft� ftrnom m
<br /> J J. Product Pressure per 1• heightOi°PSI Tante No. I 10,0
<br /> WATER Test Pressure FormLda TiyM y�S v y r;
<br /> PTH E (,.�_ .036 : 4,5-(.0 iLeakage Indicated
<br /> x .o 3d _ x� Technician wuc CLO'f7V"
<br /> 'E*'6T Date Tested 3- f-`I u
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