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®®R � 9� 416 2nd Street Galt CA 956 . Spill Bucket <br /> AFF (209) 744-0112 (209) 744-0116 FAX Test Report <br /> { r TEST DATE <br /> SITE NAME t� Vt•O (D Lty�'► r( - PHONE ('pZDt <br /> ADDRESS E . Ke CONTACT: 5t,/1 y <br /> GT i <br /> Inspector: Present / Not Present <br /> 3. SPILL BUCKET TESTING INFORMATION <br /> Test Method Used: XHydrostatic D Vacuum ❑Other <br /> Test Equipment Used: T P Equipment Resolution: t r <br /> Identify Spill Bucket(By Tank 1 _ 2 3 4 <br /> Number, Stared Product, etc. 1.(. 1 t <br /> Bucket Installation Type: p�Direct Bury 2(Direct Bury ,A(Direct Bury ❑Direct Bury <br /> ❑Contained in Su D Contained in Sum D Contained in Su D Contained m Sum <br /> Bucket Diameter: ;z a <br /> ( Bucket Depth: t <br /> Wait time between applying <br /> vacuum/water and start of test: Q <br /> Test Start Time(TO: f f / /&- <br /> Initial Reading(Rj): 02 oZ /;Z <br /> Test End Time(TF): / <br /> Final Reading(RF): <br /> Test Duration(TF-Tj): �- <br /> Change in Reading(RF-RD: <br /> Pass/Fail Threshold or _ �16 <br /> Criteria: <br /> Comments - (include information on repairs made prior to testing, and recommen e o low-up for failed tests) <br /> Test Water: Taken with tester Left on site <br /> I hereby certify that all the information contained in this report is true, <br /> accurate, and in full compliance with legal requirements. Technician:' Lyle D. Nimmo <br /> ICC#: 5249115-UT <br /> Signature: OTTL#: 97-1143 <br />