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WORKS11111"ET FOR SUMITTAL TO GOVERNMENTAL AGENCY <br /> • OWIIF.R/OFF.RAiOR kAl <br /> �����✓ �!sl]'�/[�� SITE ADORF,SS./tj /(� �L /D�J�• <br /> Ci TT Ta G�T�+��-� GA_ COUNT,- �/TJ�I t;� <br /> / <br /> HAILITIC ADDRESS :r"s �j A <br /> SITE AGENT _�1-.9Q1�5 LEdB.��.Q_ TELEPHONE i7 ) <br /> ARRIVED TEST SILT700 Hot7Rs ?AtTR LOCAIIon rRODUCT_ <br /> BDATE/TOM, STORAGE FILLED 2 1Q rRODUCT LEVEL AT ARRIVAt-2-yIHCHr.S Brum Tor OF FILL 1"1I14AL TANK S1ZF, IOQOQ <br /> TANK MATERIAL ArrROK. TANK AGIZST/TRS. FI11,sIZE/irm g OVERFILL CONTATIIITENT TY�FF,___ <br /> Ary CRAVITT-3!•7 AT � DEC. F. - Art CRAVITT OF311 60F - CnFTFTCTF.TtT OF "rAN910N of ,000 44010 - ME -14 d <br /> VISABLF VENTING ArtRPARS TO BE AT! FILL "TT) GILL OrOSt7E FUD HAS BURT TItRE, HAS BALL Clim, UNrNOWI7, OTTIF.R <br /> VISABLE. VArOR TRArs TO BE BLED! BALL CHP.CR3. HANWATS. RETURN LILIES, OTHF,R %4AIAG LRI�L Gu��7 <br /> PHASE II VA►OR RFCOVtRT S,SIt)1t BALANCED.. ASrIRRATOR ASSISTFD. I.onr. RULI WF.T,LB. HJ11ITfOLDPT), NONE. OTHER <br /> r1111PTITC STS10ft SUCTTON. URAIN HAt,F_ KED < "!gbZfZ-7' NODS rirE LINT LEAK Detectors TES LA0; noQT AQrrLQtC <br /> CHARTED SIZE q9 8'!� EST. LINI�EE QUANTITT_$ FRODUCT ADDED TO FLOOD STSTRI�ST3Te1 TOAAL CAI,I,OI/ACF._ L y O <br /> AlMIEUT CONDITIONS! Tritrt rREIEST_O rOSTFST RUIHIT CLOUD RATNINr, WIttni, RRT.E". NICHT. OTTit.R _ <br /> .4 rSI DRor094-:�nOURS TEST TO START/245"ouRS TSI TO BE HAINTAIHEb OLI TAITr BOTT(711 DURING TEST rFRiob fflxO rSt <br /> A. !.PAM. TO TALAR ROM" <br /> A. GRADE TO TALAR Tor 1_-- <br /> C. TALAR DIA"l q¢ <br /> S•P/1AF _ —Z� <br /> &V - <br /> TIST <br /> - D. TP_ST L*VP.L AMVE oPAM <br /> R. E7tTERlIAL CAOOIID MATt?R APOVE TALAR <br /> 161 rTOP Or rltl. To POM. AT ARRIVAL0. mr or PILL To Tor or TALARH. TP.S7".l.%TrC'Te tor"m" TANK rst rrR 1NCIi or rRnm" y 731 <br /> HEtarr PREssm mmnA <br /> 41f <br /> H, r51 _ �1 NFt r51 <br /> RrrIARKS! <br /> RESULTS <br /> / HIE FLNAL TEST' P RIOD AS SHOWN ON THE ATTACIIEI) COMPUTER GF,NERA'TFD DATA RrFI,EC'i'S A <br /> LOS / GAIN OF- CALLONS PER (TOUR, WI'T'H A 99% CONFIDENCE LEVEL OF <br /> TIM HORNER EZY CHER II TEST METHOD COlfrLIES WIT11 ErA AND TILE STATE. OF CALIFORNIA PERFORMANCE STANDARD OF 0.05 GFH <br /> FOR TANK INTEGRITY TESTING. (SECTION 26443 CALIFORNIA CODE OF REGULATIONS) BASFD UrON THIS STANDARD, THE RESULTS <br /> SHOWN ABOVEI DOES DOES NOT INDICATE, AN UNAUTHORIZED RELEASE EQUAL TO OR GREATER THAN THE 0.05 GrH STANDARD. <br /> INTEGRITY TANK TEST IT , -,RVICFS, 166 FRANK WEST CIRCLE,, STOCKTON, CA., 95'2106,y, (209) 466-8036 or ;(97) 262-8378 <br /> CERTIFIED TESTER 11 STATE I,ICENSF. / I- �I// TEST DATE, _�7— <br />