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CRISP TANK TESTING port Test Re <br /> 14D W. ALDER � � a <br /> STOLKTON, CA 95204 Underground Storage Tan! <br /> HORNER SYSTEM <br /> OWNER OF SITE <br /> ADDRESS OF OWNER�0L) At) <br /> )u ,b/ 6 CITYy ,/ / STATE Cc2 a <br /> _ZIP 9 � V/ . <br /> OWNER OF TANK /-E / // <br /> c l l cz <br /> ADDRESS OF OWNER �0 /�?GX CITY TATE�_ZIPC15a �, <br /> NAME OF OPERATOR AT LOCATION_ _ ZL- /' L <br /> ADDRESS OF LOCATION J/ .?K r 0 o CITY L O CZL_STATE_LO_ZIP <br /> NAME OF COUNTY_S�n h ,) nQ o( / <br /> TANK # ON PLOT PLAN LOCATION. STORAGE SYSTEM FILLED; DATE_�7 TIME 6 P/,y <br /> DATE OF TEST-2Z22—,LTIME OF DAY: START 3 3 o 7 0�21FINISH . <br /> LENGTH OF TESTj-//,k5 , AIR TEMPERATURE �J(� <br /> DISCRIPTION OF TANK-CAPACITY Z C ) DIAMETER,0 METAL k FIBERGLASS <br /> TYPE OF SYSTEM- SUCTION SUBMERSIBLE OTHER <br /> TYPE OF VAPOR RECOVERY SYSTEM p P_ <br /> TYPE OF PRODUCT BEING TESTEDWeg 90r, MEASRURED GRAVITY E`) COEFFICIENT•06j_(g <br /> TEMPERATURE OF PRODUCT / <br /> MEASURED WATER IN TANK Q DEPTH OF TANK TOP FROM GROUND LEVEL '7ZO <br /> DEPTH OF GROUND WATER h Pw u/ ,� U HEIGHT OF LIQUID LEVEL IN TEST STAND OR STAND PIPE J <br /> AGE OF TANK AND LINES ,q /4 <br /> RESULTS OF TEST: CERTIFIED TIGHT: YES_>L_NO__. IF NO EXPLAIN IN REMARKS BELOW <br /> LEAK RATE PER HOUR: + <br /> REMARKS BY OPERATOR <br /> NAME OF OPERATOR �p f9 r� G rip <br /> SIGNATURE OF OPERATOR �v/ S-' � <br /> DATE_ 7— ,;? q - X b <br />