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Crisp Tank TAting & ConstrucP <br /> on Company <br /> Phone (209) 931-1828 Licensed <br /> Post Office Box 30487 LICENSE -92-12.48 Insured <br /> Stockton, California 95213 <br /> II**TEST 11REPORT'** LEONARD k, CRISP <br /> OWNER OF SITE: `,/)/IJ AAD XI � �,J(i PAI lk(A�> <br /> ADDRESS: (� Com. (�{�c_l CITY : ZIP <br /> ---- -- - <br /> OWNER OF TANK S:'�hfOdpaI vlix/) <br /> ADDRESS: /Q1 C �!/1/� I { `I%�CITY : ,, j�I (� ' 71Y ) 2LZIP: <br /> OPERATOR AT LOCATION: ja o-A (Lao/e- <br /> ADDRESS: CITY: ZIP: <br /> COUNTY:C TANK #: AGE: GALLONS <br /> METAL(\ ) FIBERGLASS( ) SINGLE WALLED(X) DOUBLE WALLED( ) <br /> DIESEL( ) UNLEADED(. ) PREMIUM UNLEADED( <br /> WASTE OIL( ) KEROSENE( ) AVTATLON GAS( ) jF'T FUEL( ) WATER ( ) <br /> SUCTI ON O SUBMERSIBLE( ) OVERSP I I.,L CONTAINER--YES( ) NO(X) <br /> SHEAR VALVE--YES( ) NO(.KO IN-L-INE LEAK I)E'I'ECTOR--YES( ) NO()() <br /> VAPOR RECOVERY SYSTEM--YES(/0 NO( ) *IF YES , PHASE 1V' ) PHASE 2(.)() <br /> TANK FILL DATE: + 'TIME: <br /> TANK TEST DATE:_ �fi START:_()'7/ _END: if) ' - LENGTH OF TES'[': L? /1"; <br /> TANK BOTTOM TO GRADE . . . . /2_9 TEST LEVEL TO TANK BOTTOM %j;_l <br /> TANK TOP TO GRADE . . . . . . . J GROUND WA'T'ER ABOVE TANK . . r� <br /> DIAMETER. . . . . . . . . . . . . . . PSI . . . . . . . . . . . . . . . . . . . . . ,L)',���, <br /> TEST LEVEL ABOVE GROUND. G�Jt NET TEST PRESSURE . . . . . . . . . .,'_� .3 <br /> WATER IN TANK . . . . . . . . . . . API SPEC GRAV. . . . . . . . . . . . <br /> � �J• <br /> DEPTH FOR TAKING SAMPLE . <br /> 1�� TEMP. . . . . . . . . . . . . . . . . . . . 7t� <br /> TEMPERATURE PROBE DEPTH . 3 % API SPEC GRAV C 60 ' F . . . �&' 3 <br /> COF..FICIENT OF EXP. . . . . . . . ' UCC <br /> CERTIFIED TIGHT--YES( ,<) NO( ) 1,FAK RATE PER/HR : + <br /> PRODUCT LINE TEST--PASS( ) FAIL( ) SUCTION( ) PRESSURE( ) <br /> CERTIFIED TIGHT-,-YES( ) NO( ) LEAK RATE PER/HP.: + /- <br /> DATE: 4_a� -SIGNATURE"c%0 ; <br /> OF TESTER : `'71 'C <br /> COMMENTS : <br /> REV 3/92 <br />