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G—risp Tank TAting & Q'i.- sirkicifon G4:.ampany <br /> Phone (209) 931.1828 <br /> Post 0111ce Box 30487icensed <br /> kt <br /> Stocon, Coliform❑ 95213 LICENSE 4192-12`iNInsured <br /> l.Ept�lAl?I) F. CRISP <br /> **'PEST REPORT'** <br /> OWNER OF <br /> SITE- <br /> ADDRESS:�O7/ r 7CI'I'Y : <br /> OWNER OF TANKS: <br /> ADDRESS: --- - - --- ---- <br /> CT'I'Y : _ _ , _ _'7,71' •_ _ <br /> OPERATOR AT LOCATION:-�z r/ <br /> ADDRESS: CIT77" :., -- — - Z1 P : -- <br /> COUNT ! _TANK #: rte— A(tE : ,ALLO[JR : � CrCiC)-- - - <br /> METAL(') FIBERGLASS( ) SIAJr71.E WALLIiI)(m DOUBLE WALLET)( ) <br /> DIESEL( ) XUNLEADED(k ) PREMIUM <br /> WASTE OIL( ) KEROSENE( ) AVIATION GAS( ) JET FUEL( ) WATER( ) <br /> SUCTION( ) SUBMERSIBLE( k) OVERSPILL CONTAINER--YES( ) NO <br /> SHEAR`%VALVE--YES(X) NO( ) IN-T,INF LEAK DE'T'ECTOR--YES(y) NO( ) <br /> VAPOR RECOVERY SYSTEM--YES( ) NO( ) *IF YES , PHASE ). (,O PHASE 2k) <br /> TANK FILL DATE: l/� 9&T IMF: — <br /> TANK TEST DATE/ 3 S'i'AR'P:� L,ENCTH OF <br /> TANK BOTTOM TO GRADE. . . ... j - T'I< 'C LFVi?I. 'I'O TANK ISOTTOM._ f� <br /> TANK TOP TO GRADE. . . . . . _ h� <br /> L � _ � 1'UIIIJI� ldrA'I1, R ABOVE TANI, . . <br /> - -- <br /> DIAMETER. . . . . . . . . . . . . . . — !l7 SI . . . . . . . . . . . . . . . . . . . . . . <br /> TEST LEVEL ABOVE GROUND._ <br /> WATER IN TANK. . . . . . . . . . . G—s— r;RAV . . . . . j3, J <br /> DEPTH FOR TAKING SAMPT,E ._ Oc�_ Tv pill <br /> TEMPERATURE PROBE DEPTH . <br /> r�nliEJf' II;IfI OF FXI' . . . . . . . . <br /> (J ,��,-7 <br /> CERTIFIED TIGIIT--YESO') No( ) 'AK PER/HR : + (J <br /> PRODUCT LINE TEST--PASS(k) FAIL( ) SUC'I'10N( ) PRESSURE(x) <br /> CERTIFIED TIGHT---YES( ) NO( ) . I,EAK RATE PIiR/HR: + _Q- <br /> G/�/ <br /> COMMENTS: /ZOiiJi✓F - s� ' d �!�E/{�� <br /> DATEt- SIGNATURE OF <br /> v <br /> REV 3/92 Gam <br /> t <br />