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OCT-25-2007 17:55 CITY OF LODI 209 333 5710 P.21 <br /> I <br /> I <br /> 416 2nd Street Galt CA 95632 Spill Bucked <br /> AF'FORDA-TGV <br /> (209) 74' 4-0112 (209) 744-0116 FAX Test ReP ortl <br /> TEST DATE Z a <br /> SITE NAMEr,v Z,or <br /> PHONES <br /> ADDRESS 133 13, A M _ . LN CONTACT: �ENtif 1 <br /> Ins ector: PA o po tJ Co To v�cL Present / Not present <br /> I <br /> 3. SPILL BUCKET.TESTING INFORMATION <br /> Test Method Used: H ostatic ❑Vacuum 0 Other <br /> Test Equipment Used: Equipment Resolution: <br /> Identify Spill Bucket(By Tank 1 2 3 4 <br /> Number,Stored Product, etc) gM <br /> Bucket installation Type: Direct BuryDirect Bury Direct Bury 0 Direct Bury <br /> ❑Contained in Sump I]Contained in Sunip ❑Contained in Sump ❑Contained in S <br /> Bucket Diameter: 12— i (X, <br /> Bucket <br /> s- <br /> Bucket Depth: 13 I z Z3 1A.- <br /> Wait <br /> .- <br /> wait time between applying <br /> vacuuuVwater and start of test <br /> Test Start Time(TO: . 1650 1050 q3o <br /> bitial Reading(RO: U b 10 5 <br /> Test End Time(,,): 6 115 O 050 <br /> Final Reading a4): 5/25- <br /> Test <br /> :5Test Duration(Tp—TO: F}.!L 112— <br /> Change <br /> IzChange in Reading C4-N:. <br /> PwaTail Threshold or �- <br /> Critesia: <br /> COI21111C - include in ormation on re s made rlor to teatin ,and recon ntende ollow-u ar ailed tests. <br /> Test Water: QTaken wittester Left on site <br /> I hereby certify thatall the information contained in this report is true, <br /> accurate, and in full compli i legal requirements. Technlclam , Zane A. Nimmo <br /> ICC#: 5263322-UT <br />