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CPISIJ TANK TESTING �� <br /> 1 CON-1-PUC] ION Co. <br /> P.O. [IDX 30480 LICENSED <br /> SIOCKTON, CA 95213 INSURED <br /> (2.09) 931- 1020 <br /> FAX (209) 465-3806 <br /> ' "TEST* * *TEST REPORTLICENSE ii'92-1248 <br /> 1 �/� LEONARD F. CRISP <br /> O�VNF.R OF STTF,:J�_� <br /> D � �1 _ _(�Lt(e, f.'�Y.CU --- - - _ . ._. <br /> O NER OF TANKS: - ---------�J �-- �� 6&JDJ ✓ <br /> AUDRF,SS:-------- --- - - -- - . <br /> CITY: ZIP:,- <br /> OPERATOR <br /> IP: _OPERATOR AT LOCATION: <br /> ADDRESS:__._.._ -- CITY: _ _ _ _ ._ ZIP: _ <br /> COUNTY(- �- �( L�. _. TANK#:._.-. AGE:- <br /> MF.TAT,("4) FiBi-'RGT.ASS( ) SINGLF. WALI.FD(Yy DOIJBI.F WAI,I.FI)( ) <br /> DiF.SF.1.( ) UNLEADED ( ) PREMIUM UM.. <br /> SUCTiON("y SUBMERSIBLE( ) OVERSPiI,I, CONTAINER**YRS( ) NOW <br /> SHEAR VALV)',"YES( ) NO(q ) iN-LINE LEAK DF.TFCT'OR"YF.S( ) NON) <br /> VAPOR RECOVERY SYSTEM**YES(IJ) NO( ) IF YES, PHASE IM PHASE, TI(v� <br /> TANK FiLLTTMF:...-------- --__-.-- <br /> TANK TEST DATE-9c3k-:'�- START:)_1Qu_ -. FND:.QcIu)-- <br /> LENGTH OF <br /> TANK BOTTOM TO GRADE.....__04___" TEST 1.1:VF1, TO TANK BOTTOM.......__� <br /> TANK TOP TO GRADE............-_4Q_" GROUND WATER ABOVE TANK.....--_______." <br /> DiAMETER.... ...................... -- -- _' PSI...................................................... .0,7 <br /> TEST LEVEL ABOVE GROUND.-_�__" NET TEST PRESSURE....................... .. <br /> WATER iN TANK.....................---_&_" APi SPECIFIC GRAVITY................._�J�-T�__ <br /> DEPTH FOR TAKING SAMPLE...-1,�__" TF.MAF.RATtTRF...................................�"# <br /> TEMPERATURE PROBE DF.PTH....�Z_" APi SPECIFIC GRAVITY(& 60' F......- _ <br /> COEFFICIENT OF EXP......................A �O__4 b] <br /> LEAK RATE PER/HR:+ _ . ./-_.•_( <br /> CERTiFiED T1GHT: YF.SN-) NO( ) <br /> PRODUCT LINE TEST: SUCTION( ) PRESSURE( ) <br /> i.F.AK RATE PFR/TIR: <br /> CERTIFIED TIGHT: YES( ) NO( ) <br /> DATE,: _ _ - '/ '___-- S iGNATURE OF TESTER: .- : .,Q� 7iUG�.e -- -. _ <br /> COMMENTS:-- ------ - ------------ -- --- -- --- ------- ----- ------- <br />