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WORKS*FOR SUBMITTAL TO GOVERNMENTA NCY <br /> OWNER/OPERATOR ��/"/��/�LliU j j�/g��(��J SITE ADDRESS /d` S- <br /> CITY .} 7'�C` C�J' � COUNTYJ�' J <br /> MAILING ADDRESS 9-5-zQ5- <br /> SITE <br /> - <br /> SITE ACENTTELEPHONE <br /> ARRIVED TEST SIQ 7--;r Q HOURS TANK LOCATION ©/ T' //v `� PRODUCT <br /> DATE/TIME STORAGE FILLED ///3,4�RODUCT LEVEL ATARRIVAL IINCTIES BEIM TOP OF FILL "INAL TANK SIZE��C� <br /> TANK MATERIAL PP <br /> � .., AROX. TANK AGB/7/-LTRS. FILLSIZ£/TTPE 4 OVERFILL CONTAIRIMU TYPE <br /> AFI GRAVITY 41,06 ATbyO UEC. F. API CRAVIT7( OF @ bOF COEFFICIEN3 OF EXPANSION OF .000Zf�4 - COE�U <br /> V;SABLE VENTING APPRPARS TO BE ATI FILL END, ILL OPOSITE END, RAS BURP TUBE, HAS BALL CHECK, UNKNWN, OTHER <br /> VISA-BLE VAPOR TRAPS TO BE BLED: BALL CHECKS, HANWAYS, RETURN LINES, OTHER <br /> PHASE II VAPOR RECOVERY SYSTEM: ALANCED. ASPIRATOR ASSISTED, LONG RUN {TELLS, MANIFOLDE:D, NONE. OTHER <br /> PUMPING SYSTFSI. SUCTION, TURBINE HAKE /��,J� MODEL 2PIFELINE LEAK Detectors YES, N0� of APPS IC <br /> ARTED SIZE 1 5 EST. LIRE QUANT'ITT/a PRODUCT ADDED T *FW <br /> OI)FOD / <br /> SYSTUi � SYST TORAL GALLONAGE__._=J 1 <br /> CHz� <br /> AMBIENT CONDITIONS: TF2IP: PRETEST�a POSTEST 4V 6UNNy CLOUDY, fiAININ INDY NIGHT, OTHER <br /> 4 PSI DR GTC�HOURS TEST TO STAR�L ��ROURS PSI TO BE BE MAINTAINER ON T HOTTOt! DURING TEST PERIOD J, �"PSI <br /> A. GRADE T'0 TANK BOTTOM f <br /> 'L B. GRADE TO TANK TOP <br /> C. TANK DIAVETER 7s <br /> 6Pi'4.DE �� <br /> D. TEST LEVEL ABOVE GRAlSE <br /> XI" F '6/1!L)yL �_ E. EXTERNAL CRO" WATER ABOVE YANK <br /> X ,0361 PS! t <br /> F. TOP OF FILL TO PiOO. AT AARJVAL <br /> C. TOP OF PILL TO TOP OF TANK <br /> N. TT!BT:,llam'TO BOTTON 0; TANK <br /> 77 PSI PER INCH OF PRODUCT <br /> MATER INSIDE <br /> TANK TEST HEIGHT PRESSURE FOMMA <br /> E <br /> 3- �96 <br /> H. PSI F. PSI NET PSI <br /> REIIARK S <br /> RESULTS <br /> IE FINAL TEST P RIOD AS SHOWN ON THE ATTACHED COMPUTER GENERATED DATA REFLECTS A <br /> OS / GAIN OF:,In _ GALLONS PER HOUR, WITH A 99% CONFIDENCE LEVEL OF i/ - tai gph. <br /> L . <br /> THE HORNER EZY CH ME 0 COMPLIES WITH EPA AND THE STATE OF CALIFORNIA PERFORMANCE STANDARD OF 0.05 CPR <br /> FOR TANK INTEGRt Y STING. SECTION 2649 CALIFORNIA CODE OF REGULATIONS) BASED UPON THIS STANDARD THE RESULT <br /> SHOWN ABOVE: 3 DOES NO INDICATE AN UNAUTEORIZED RELEASE EQUAL TO OR GREATER THAN THE 0.05 GPH STANDARD, <br /> INTEGRITY TANK TE T N RVrI�CES, P.O.BQX 691376 STOCKTON, CALIFORNIA, 95269 (209) 474-1375 or (800) 262--8375 <br /> CERTIFIED TESTER v STATE LICENSE NEST DATE U✓�LJJ <br />