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Data Chart for Tank System Tightness Test <br /> �± petro T1fP <br /> PLEASE PAINT TANK TESTER <br /> 1. OWNER Property see <br /> ® n.m" 7 weer A.wrwe.maarWe TNseron. <br /> Lnkla) <br /> "Nrr wNrY. 11gwe.nrrwe fNMnsne <br /> 2. OPERATOR <br /> Ww" •wrw Ter.ellero <br /> I. REASON FOR <br /> TEST <br /> IExplain Fultvl <br /> 4. WHO REQUESTED ­&A11 - _ <br /> TEST AND WHEN "'"" ""• �'"r'"•«w"w'""" °^• <br /> --- <br /> weereY fNNInOM <br /> 5. WHO IS PAYINGi <br /> FOR THIS TEST? CNwNey.we.wcy e,I.m.wu.r -" T..w�w�rrowl.h tin. -- rNeonon.— <br /> atlw"wwNr. Cor six" Ila <br /> Oras He. Ura"Imtwcheq - <br /> ' lowest,pt,Direction Capacity ara,M/Svpplw Grade Agents.Aye SteN/FlbwryNw <br /> 6. TANK(S) INVOLVED + / / O <br /> Leven C. Filh Veru Sperm pump. <br /> f7. INSTALLATION /i1�/ZL47 �vCj <br /> DATA -Z;Pv�VA <br /> a.err krYw wrlr"." CewcrN.,aid Two. SUP.TIMr"els.Drove !.coke.a«rote. <br /> msec et auxo,r,cmc. 4M..r, ween A."or.ea we.M.MM"Or Wrur coker state a knave <br /> 8. UNDERGROUND /i Is low wow ow the Unit? <br /> WATER Olson to the Www rte ��� f ❑ rw ®J10 <br /> Tanks to be sled In. OaW O <br /> w Anorryr <br /> 9. FILL-UP ft.. Tosses+. <br /> ARRANGEMENTS Extra oreAuct to-lop off"and run TSTT. How one who to provieo I Coneldv NO Lxxd. <br /> I Terminal or,ptlw ContNt <br /> for else p npymy <br /> Combas N.w. Te"on... <br /> 10. CONTRACTOR. — <br /> I MECHANICS, <br /> any Omr contractor <br /> nvolvad <br /> 11. OTHER <br /> INFORMATION <br /> OR REMARKS <br /> AednenN mlpmeterr on wnY n.m.•wow.Olhcels or other,to be Wvlswe when telling n in prop"..or completed.Visitors or obrwer,Present <br /> dwnry tot etc. <br /> Tests wen mads on the above tank systems in accordance with lost procedures prescribed foe _Iro Tf�. <br /> 12. TEST RESULTS as deialyd on atlKMd lost charts with results a follows; FM <br /> T& <br /> IdenOlication Tight - Leakage Indicated Data Tested <br /> 11. CERTIFICATION 1hels isltwna«Flr that <br /> tththe" <br /> tank <br /> k«Inloa Pamphlet 729. Ne data(s)shown.The"indicated a"Tight"meat the critwta ostablletled by <br /> ACCUI'TATF TA"1' -_STING, INC. <br /> _fid- om �J P.10-30-�"',�'r�,o.w <br /> ANTIOCH, CA 945 <br />