Laserfiche WebLink
O 04 oOWNER OF SITE <br /> CRISP TANK TESTING S $ G U y f n <br /> 11 <br /> Stockton, CA li R952053 3 I r / ADDRESS <br /> TESTING METHOD �7 <br /> 6 o 6 I MAR 151988 WORK SHEET � `� � 3 CITY-STATE•ZIP CODE <br /> ENVIROMENTAL HEALTH �O brU i- c <br /> -� <br /> ' / nFERMIT/SERVICES f OWNER OF TANKS <br /> TANK No. G TEST LEVEL �` t' PRODUCT K on C% X s CAPACITY OQ CHART CAL , __ � to . •DQ,� f/(A) <br /> T 4 <br /> MEASURED GRAVITY ��j PRODUCT TEMP �� COEFFICIENT �g�� TEMP CALD�oG/�`� 5 ADDRESS� 190r) 1) s � ? ` 2> S) rr <br /> Air Temo <br /> TEST LEVEL LEVEL GAIN+ x(A) LEVEL TEMP. TEMP. GA114+ x(8) TEMP, FINAL CITY-STATE-ZIP CODE <br /> NO. START END LOSS— x (A) RESULT START END LOSS— x(e) RESULT RESULT TIME ^� <br /> sl ") i .l I I i, ✓ n I a V �� r v. l♦� s �J J C t. J r t r OPERATORS NAME AT SITE <br /> TYPE OF SYSTEM <br /> ❑SUBMERGE SUCTION <br /> / r' LENGTH OF :t <br /> 7 �/ (/ l �. 4 . V > 1, `` ✓ / `t I COLOR CODE OF PUDU, <br /> —"-'-•- -' --'--�� I ' � ✓ PILL PIPE <br /> _ CLEAR ORANu <br /> X = — X s ` / J (f RED <br /> '✓ J 7 ' /✓ l I �) y) �' {� �. /. j {- 1 i DIAMETER OF TANK <br /> f - ! ❑ METAL <br /> V 'x ^ Q 1 — s s c ❑ FIBERGLA <br /> i� / / ✓4 / �, O a O ,�,. /� ' r 5,ry.L /)© 7)C r V f TYPE OF RECOVERY SYSTEM <br /> n f V ❑BALANCE ❑ RED JACKET [DHF-AL! <br /> s % xL�i�/ �`i !� I `l F7 I ) T7 O (U r U t� l �, .~i., s , '?J h i i ~,. WINTER LEVEL IN TANK <br /> - Liquid level <br /> xOJ/ 9 D .141 � � X � �� 490 <br /> _ DEPTH OF GROUNDWATER _(IF KNOWN) <br /> 3 u , J <br /> DATE/TIME STORAGE SYSTEM FILLED <br /> `'� ( - "7 DATE TIME <br /> STATION LOCATION ��" y' CERTIFIED TIGHT <br /> AGE OF TANKS <br /> ADDRESS !q / �' I^` P LEAK RATE PER HOUR <br /> 1 ATC ' OPERATOR C= 0 ! ..x '� �, tr ' _._j AGE OF LINES \ J <br /> QATE '- R _' SIGNATURE F t+ r e <br /> TESTING FLUID.IF DIFFERENT THAN <br /> f'%IPI „ ,��., _ S70REi0MATERIA1 <br />