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thampion P.O. Box 130.59 <br /> Sacramento. CA 95813-3059 <br /> Precision Tank Testing CA 800.660-9443 <br /> License No. 73848 <br /> NEV 800-949-9443 <br /> (915) 927-1557 <br /> Fax: (916) 927-7345 <br /> HORNER EZY-CHECK CERTIFICATION <br /> Property <br /> Owner : C * a S 72,c./c 7-6 <br /> c� / GU, �/-ds rr`'i�yir 7 N T <br /> Address : � <br /> Tank Address : <br /> *Notice to oxner(s)* A copy of this test result has been filed with the proper regulatory <br /> agency. It is the responsibility of the owner(s) to contact the local Env. Health Dept. in <br /> his or her area of any tank failure within (24) hours of testing. <br /> Tankn Product Capacity Apx. Age Steel Fiberglass Supplier <br /> Tank( s ) were filled on: t- Jz - _ /&,c)t;, Distributor : -,T103, P <br /> Date Time <br /> Extra product to top off:_No[4/ Yes[ ) Gallons <br /> Comments : <br /> TEST RESULTS INCLUDE <br /> Tank(s ) Product Line( s) v Vapor Recovery System Vent Line(s ) C,- <br /> Tank <br /> Tank Tight Tight Leak indicated Leak indicated Date of <br /> ID# Tank(s) Line( 2) per hr. ( tank) per hr. ( line) testing <br /> COJ60IM-P Yes[ o[ ]Yes o[ ] , a�t73 -7-- /3_g ' <br /> Pf SFS Yes[LfNo[ ]Yes[fNo[ I - QAYy - `3 - <br /> Yes[ ]No[ ]Yes[ )No[ ] <br /> Yes[ ]No[ ]Yes[ ]No[ l <br /> Yes[ ]No[ ]Yes[ ]No[ ] <br /> Yes[ ]No[ ]Yes[ ]No[ ] <br /> Technician: License Date : <br />