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CRISP TAPv, TESTING 0 Coll-1 RUQ'-1 lOPJ (:0 . <br /> P.O. BOX 30407 LIiCCN►CU <br /> S10CK10N, CA 95213 INSURED <br /> (209) 931- 1020 � /1 j1 <br /> FAX (209) 465-3006 J"" <br /> * * * *TEST REPORT LICENSE -it92-1248 <br /> � LEONAPD E. CRI)-P <br /> ADDRESS:_..._��.1k �x�t�-- c <br /> OWNER OF <br /> (:TTY: _ _.. . _.-, __-- ZIP: _ . <br /> OC i_T-3 1994 <br /> OPERATOR AT I,UCAT•ION: <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br /> ADDRESS: _ _ CITY: ZIP: <br /> COUNTY_ �T I TANK#:.._ _t__. AGE:_ _ GAI,LONS:.-IZ,OQD.._ . <br /> METALN ) FIT;ERGI,ASS( ) SINGI.E W AI,T,FD(d) DOUBI.F WAT,I,F:D( ) <br /> DIF,SF,L( ) UNI.F,ADED ( ) PREMIUM UNI,. (W <br /> SUCTION(?) SUBMERSIBI,F.( ) OVERSPILT, CONT'ATNFR*`YFS( ) NOX) <br /> SHEAR VALVE**YF,S( ) NO(�C-) IN LINT I.EAK DFTFCTOR**YF,S( ) NO(�a) <br /> VAPOR RECOVERY SYSTEM NO( )) IF YES, PHASE PHASE. TT(�d) <br /> TANK FIT,I. DATE:-31.- <br /> TANK TEST DATE,: 'a.-Y�fSTART:-(-)7_ U-G-_ <br /> T,FNGTII OF <br /> TANK BOTTOM TO GRADE...1-2-_6_---" TEST LEVET, TO TANK BOTTOM...�G_ <br /> TANK TOP TO GRADE............ GROUND WATER ABOVE TANK..... 47 <br /> Di A METER...:......................... - >_- PSI...............................:: -- - <br /> �._ <br /> TEST T,EVFL ABOVE GROUND._ .,p2_._." NET TEST PRESSURE......................... •l.G___ <br /> WATER IN TANK.................... API SPECIFIC GRAVITY................. _5-7,__8j.__---. <br /> DEPTH FOR TAKING SAMPLE...g_C) TF,MPFRATURF..................................�94 <br /> TF.MPF,RATURE PROBE DEP'CTT..3_ API SPECIFIC GRAVTTYc+ h0' - <br /> ...._ <br /> COEFFICIENT OF EXP......... <br /> LEAK RATE PFR/ITR:+_.-.- <br /> CF,RTIFIEI) TIGHT: YES(?<) NO( ) <br /> PRODUCT T,INF TF,ST: SUCTiON(I PRESSURE( ) <br /> I,FAK RATE PER/HR: <br /> CERTIFIF,D TIGHT': YI:S(''C) NO( ) <br /> DATE:_d^ 7 -1 _. _ _-. SIGNATURE OF 'I'T:ST'ER:_. _ __ <br /> - <br /> COMMENTS:-----.---.-- <br /> -- <br />