Laserfiche WebLink
WORKSHEET FOR SUBMITTAL TO GOVEfLYMENTAL AGENCY <br /> <<� r /r/ r <br /> DATE STORAGE FILLc0✓�1'%�NINE STORAGE FILLED. )MJ PRODUC." LEVEL ) ARRIV.AL /^ 1"7PRODUCT. �t <br /> TANK CAPACITY ee-e AMOUNT OF PRODUCT ADDED TO FLOOD SYSTM TANK LOCATION 7[/ <br /> REMARKS <br /> LIQUID LEVEL GLiSRATICNS TOP CF FILL 70 STM OF TANK 'NATER PRESENT PRETEST POE POSicST Y16 <br /> � <br /> PRETEST POSTEST y� ��!/ / <br /> !y„ � �� TOP OF FILL 'L`P CF TANK L <br /> � / INCHES ABOVE GRADE I TEST START / �Y5' � <br /> LINES 6_ /�C _ <br /> / EYD <br /> TANK DIAMETER Y�y ;fc <br /> TEMPERATURE CALI3RATICNS / <br /> MOVEMIEN?, `Lly _ A.P.i. PRODUCT GRAVITY 3A�Z F GRAVITY OF�` 160 <br /> 1 <br /> AVERAGE _.a- <br /> ,O< � �3 0c�-C, S .�C� � <br /> IQUANTITY ADDED = LINE �C1E:FNT -LIQUID COSSL4NT ;A) lOEFFi CLEY JF EXPAN510N x TA t,7777Y TEMPERANRE XNSTA:Ni 13 <br /> .:'Z4t7T END GAP7 + T.7-IES Ls J_'L ST4RT Fill DGA_7+ TI::+ES ='E7p. FI`.iAL <br /> mrr rrc LEVF'L LEVEL LOSS - CONS A = RESULTS TEMP. TEMP. LOSS - CONS B = RESULT RESULTS <br /> I c7 1 __19 .scz :c0 / c . `cc3 ! 0iK I'c /�s 'c. v <br /> y % D C_ cc1c,9 7FZ <br /> �/ I �D� 53e I . erfc" Gchr I ;Ce° 70 19 ley( <br /> C'-.2;Z 4: 179- ; ,oc3l I 'c1`fS <br /> X93 2c r 'c c C e lc9 <br /> 1 <br /> j 3 :c �/ 7 9 'oc�- `cc 0 `cc518 15 <br /> L� HOUR OF <br /> OWNER/OPERATOR C �{C� ✓S <br /> Cy LLf"s TESTING REFLECTS LOSS / GAs.I OF: <br /> SITE ADDRESS / 3O ( .�.dc 7 ORNER EZY CHEK METHOD OF PRECISION 'STLYG 'HE RESULTS: <br /> :i— ..f .43E .70T +I':'?:7 IHE STATE OF CALIFOANTA AND '711E NFP.A <br /> MAILING ADD�FS S .�c.ilvr-���c. LNES OF A %WIMIM LASS OF .DS GALLONS PER ONE HOUR OF <br /> ;--�f� // TESTING FOR A TANK SYSTEM TO BE CONSIDERED TIGHT. <br /> CITY f�l�(.L/i ��� <br /> -� INTEGRITY TANK TESTING SYSTEMS, IAC 166 FRANK ',(EST CIRCLE <br /> COUNTY STOCKTON, CA. 9S206 9) 366 O;V CSOO) 262-8375 .y}, 2 <br /> TELEPHONE (_ ) CERTIFIED TESTER // ;EST DATE / l7 � <br /> AGENT <br />