Laserfiche WebLink
WORKSIfEET FOR SUBMITTAL TO GOVERNMENTAL AGENCY <br />OWNER%OPERATOR �^-7�+�//�JijjCX�// ��i"Uf/�%�%SITC ADDRESS— <br />CITY Li'��CYt� COUNTY <br />HAILING ADDPE95 <br />SITE AGETTTr� d�[YCJ TELEPHONE <br />ARRTVED TEST SITa,5�nHOUR.S TAMC LOCATION /_ y PRODUCT <br />DATE/TINE STORAGE FILLED FRODUCT LEVEL AT ARRIVAL INCHES EELOW TOP OF FILL NOMINAL TANK SIZE (��Q <br />TANK MATERIAL APFRox. TANK A00AR�775. FILLS IZE/TTFr--3 OVERFILL CONTAINMENT TTFE <br />An GRAVITTd AT DEC, F. AFI GRAVITY OF� @ 60F - COEFFICIENT OF ERFANSION OF ,000 4S7 5 - f.OES b' <br />VTSABLE VEN?1NG APFRFARS TO BE ATsIT,L FILL OFOSITE E. NAS RURP TUBE, HAS BALL CHECK, OWN T'Hry <br />VISA -BLE VAFOR TRAPS TO BE BLED: BALL CHECKS, MANWATS, RETURN LINES, OITIER <br />PRASE II VATOR RECOVERT STSTm* ALANCED ASPIRATOR ASSISTED. LONG RUN WELLS, HANIFOLDED, NONE, OIRER <br />PUMPING STSM., SUCTION, TURRIN HAKEi�fC ���HOOEL PIPE LINE LIJUC Detector TF. PC; NOT APPLIC <br />CTIARTED SIZE %� O EST. LIKE QUANTITY ` /_/ FRDDUCT ADDED TO FLOOD STSIEH -5� SYSTEM TORAL GALLONAGE !� © <br />AMBIENT CONDITIONS: 1 PRETES16-7 POSTEST , ltlt OUDT RAINING, WINDY; RREEZT, CAT, OTHER <br />.4 PSI DRO/oP {TOURS TEST TO STARII,4,39HOURS PSI TO BE MAINTAINED ON TANTO BOTTOM DURINC TEST PERIOD �� � PSI <br />A. GRAPE To TAN[ BOTTOH' <br />© 7 B. CRADE TO TANK TOP <br />C. TANK ClAYMA <br />E•P�T.l1E' <br />D. TEST LEVEL ABOVE MOE <br />7 E. XiTERNAL CRotM WATERxABO E TANK <br />IPI.1 <br />•� �� rSI <br />F. TOP OF FILL TO PAOb. AT ARRIVAL <br />G. TOP OF FILL TO TOA OF TANK ZZ- <br />(JA� H. TM7LA7EL•Td eOTTd'f OV TANK <br />MATRR IN rY' PSI PER INLTI OF rwmxF <br />Q <br />TANK a TEST HEIQTT PRESSURE FORMICA r LL <br />H. PSI £. S1 NET PSI <br />REMARKS: <br />RESULTS <br />IIE FINAL TEST PERIOD AS SHOWN ON THE ATTACHED COMPUTER GENERATED DATA RP:Fl,ECTS A <br />OSS I GAIN OF:, -/GALLONS PER HOUR, WITH A 99% CONFIDENCE LEVEL OF +/- 00//- gph. <br />THE HORNER EZY CHER II — OD COMPLIES WITH EPA AND THE STATE OF CALIFORNIA PERFORMANCE STANDARD OF 0.05 GPH <br />FOR TANK INTEG I TING. (SE TION 2643 CALIFORNIA CODE OF REGULATIONS) BASED UPON THIS STANDARD, THE RESULTS <br />SHOWN ABOVE: DOES NOT NDICATE AN UNAUTHORIZED RELEASE EQUAL TO OR GREATER THAN THE 0.05 GPH STANDARD. <br />INTEGRITY TANK TESTING(PERVICES, 41 WEST YOKUTS ST. STOCKTON, CA., 95207, (204) 474-1375 or (800) 262-8378' <br />CERTIFIED TESTER�� STATE LICENSE 6 TEST DATE <br />