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lata Chart for Tank System Tightness Test <br /> Y 9 <br /> PLEASE PRINT <br /> 1. OWNER Property❑ Beacon Oil Company 525 W. Third Street Hanford, Ca. 93230 583-3214 <br /> Tariteacon Oil Company 52'' or%". Third Street PMa"H 137d Ca. 932300'ech'"'583-3214 <br /> l� <br /> Name Address Reoresentahva Telephone <br /> 2. OPERATOR Beacon #494 2185 E. Fremont Stockton, Ca. 465-1551 <br /> Name Address ,Telephone <br /> 3. REASON FOR <br /> TEST To test System for tightness <br /> (ExPlam Fully) <br /> 4. WHO REQUESTED Julie Caldwell 6/14/89 <br /> TEST AND WHEN ,♦ams ord, Ca. 93230 583-3214�, Company 'anfaa ` <br /> j�Bacon Oil Company �DLS E. Third Street <br /> Address Teieonone <br /> identity oy Direction Caoaciry Brand/Supolier Grade Aoprox,Age Steev Fiberglass <br /> 5. TANK INVOLVED /;",j r,1 L-0,r /o/0,v <br /> v Af ., r,d ;- <br /> Use additional lines <br /> for manitolded tanks �L,'icd <br /> Location Cover Fills Vents Siphones Pumps 1(1=fie f <br /> 6. INSTALLATION v u .'"� Cctvcr cr- 3 _4 ' - <br /> DATA <br /> Noah insidedriveway, Condrete.Black Top, Size.Titefill make.Drop Suction,Remote. <br /> Rear of station,etc. Earth,etc. tubas.Remote Fills Size.Mamfoldeql Which tanks? Make it known <br /> 7. UNDERGROUND Is the water over the tank? <br /> WATER Depth to the Water table _yesNo <br /> Tanks to be filled hr. Date Arranged by <br /> 8. FILL-UP Name Teieonone <br /> ARRANGEMENTS Extra product to top off'and nun tank tester. How and who to provide? Consider NO Lead. <br /> Terminal or other contact <br /> for nonce or inquiry <br /> Company Name Tel eonone <br /> 9. CONTRACTOR, <br /> MECHANICS, <br /> any other contractor <br /> involved <br /> 10. OTHER <br /> INFORMATION <br /> OR REMARKS <br /> Additional information on any items aoove Officials or others to De advised when testing is in progress or comoieted.visitors or observers present during test.etc. <br /> Tests were made on the above tank systems In accordance with test procedures prescribed for <br /> 11. TEST RESULTS as detailed on attached test charts wtth results as follows: <br /> Tank Identification Tight Leakage Indicated Date Tested <br /> 10rr1 - -0/ 6 - 14 -57 <br /> 7 <br /> Z3 r0 0 6 l "84 <br /> 12. SENSOR 13.Thi.is to terttfy th.t Ouse be*system were tewed on the dete(r)shown.Those Indicated s-nyhr mew the criteria establwted by the <br /> CERTIFICATION Nedonar F v Pro'ttfeU, Aaeoctadon ft Will 132& <br /> Technicians <br /> �r gats (� l/2r�ro� Liquid Construction, Inc.or Company. <br /> �j t. �,D Ya 4 t U Tasting Contractor By: Slpnstuire <br /> 111; /i7J 7 <br /> Sepal No.of ThWMW Certifications 1u0 /7P.O. Box 1220 Tulare, Ca. 93275 <br /> Sensor <br /> Address <br /> 2 - <br /> CArtificallon <br /> ;a.. `f.r'-,/'�,`�,I.I <br />