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�f F®pI�®/���E T 416 2nd Street Galt CA 95632 Spill Bucket <br /> (209) 744-0112 (209) 744-0116 FAX -rest Report <br /> TEST DATE <br /> SITE NAME �9 s/��Z.,(_ PHONE (.Sl C) ) SSz - -'M L� <br /> ADDRESS 7?OO 577- CONTACT: 1'7^J 6Z � <br /> T 7-,D"j <br /> Inspector: QN �LAQQ/fA/ �/L/5 Present / Not Present <br /> ------------r <br /> 3. SPILL BUCKET TESTING INFORMATION <br /> Test Method Used: KHydrostatic ❑ Vacuum ❑Other <br /> Test Equipment Used: 'f/4P� -�U Equipment Resolution: ` 6 <br /> Identify Spill Bucket(By Tank 1 2 �,� 3 _ 4 <br /> Number, Stored Product, etc. C Tj Bucket Installation Type: ❑Direct Bury ❑Direct Bury ❑Direct Bury ❑Direc <br /> ,V Contained in Su 9Contained in Sum &Contained in Su ❑Conta <br /> Bucket Diameter: t �k �1 <br /> Bucket Depth: t 2 CO <br /> Wait time between applying <br /> vacuum/water and start of test: — <br /> Test Start Time(TI): <br /> Initial Reading(Rj): <br /> Test End Time(TF): j Y $ 5 <br /> Final Reading(RF): -3 r Z <br /> Test Duration(TF-TI): H <br /> Change in Reading (RF-Rj): <br /> Pass/Fail Threshold or <br /> Criteria: _ — <br /> �n.�aAiSiCr!a" 7:,.„ , ,niMv j , x_ r next����itrA ��. ��'i�l^`'"i �°, i.�.." s�°h_r t h wu- � ew�; ,,.u��� wr.�rcr,-w�•.. ? `�4e'a �.'A'� '�i°�"''hy"i,�"c'�� <br /> T;es�t� '�°si°�iI„t�,��( �`����;•.��, »a , �d«��,��1Y,�4��t��i,, ,P���;� s��l^ �. ,r�'��'� C]'�t ai1R1�r� bj��a�s,,� ©,�ail�ii����,, <br /> Comments-(include information on repairs made prior to testing, and recommended follow-up for failed tests) <br /> ,SLC uQc t;5 T'�jSS E 7 <br /> Test Water: Taken with tester ERLeft on site <br /> I hereby certify that all the information contained in this report is true, <br /> accurate, and in full compliance with legal requirements. Technician: , Zane A. Nlmmo <br /> ICC#: 5263322-UT <br /> Signature: OTTL#: 04-1676 <br />