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4v Y ah toMMohmess <br /> b Q <br /> o � v <br /> ASE PatRtTt".�IC11?: a 'R.Cr '�L7N�'`AN1C . <br /> No.ol 1111 11,101 one <br /> .OWNER yR&J.Qne : . . <br /> NefWr. Add##$% M bhee <br /> T 1, <br /> Reaatentehw <br /> I. OPERATOR <br /> � Tefaphane <br /> 1, REASON EORVERNING` UNDERGROUND STORAGE OF HAZARDOUS SUBSTANCES <br /> TEST ` SUBCHAPTER 16 OF CHAPTER 3 OF TITLE 23 OF THE CALIFORNIA ,ADMINISTRATIVE CODE <br /> AExplatin Fully) <br /> 6. WHO REOUESTEO OWNER <br /> TEST AND WHEN <br /> "x— Tnre tame at Affawaon case <br /> Adaeesa teNAhe^e <br /> i. FOR <br /> IS PAYING <br /> . <br /> N"RfR THIS TEST? �O�anyso"n"Fr individual f'ersM+AulAorNrne ,p ' ' Trth Telephone <br /> ®' r®fs Cite _ SuN 2M <br /> Attention of: Ordee No othet 1Mttuct.ons <br /> Identity by Direction GpeertyBrand/Supplte* Crede Appra6.Ape 5teef/fobergtass <br /> N. TAKtsa INVOLVEbe <br /> D <br /> t <br /> 000 <br /> Uj <br /> Location Cover fills Vents Stphonas Pumps <br /> 1. INSTALLATION x S m • I <br /> DA <br /> T ! � d *, ': <br /> j4 C-74is <br /> North mutoe drnewsy. .Concrete.Slack TOR. Site,TrNlelt male.Ctoo uk Suehon,fternbf0. <br /> Rear of stalrorn,etc Earth.etc. tubes..Remote fats Sire:iMerufol0•d 'Which WAS? MAake it known <br /> B. UNDERGROUND is the water over the tank i <br /> WATER Depth to the Water table ® Y. Q No <br /> Tanks to be tilted for., ®e _ Date Arranged by ' <br /> . TILL-UP <br /> Name, Ifloor . <br /> AR NGEMENTS Extra product t0 top off' and run TSTT, `;How and who to provide? ' Constof r NO Lead <br /> r4 igp <br /> Terminal or other contact <br /> for notice or inquiry S'^•• <br /> ' co-Dant }tv` Nsn+• Teypnon•. ` <br /> CONTRACTOR. <br /> MECHANICS. „ <br /> any Other corltfactor <br /> involved e <br /> I., OTHER <br /> INFORMATION �-- <br /> OR REMARKS CIS <br /> Additional information on any ett ns above offet✓ais or others to be advised when testing is to progress or completed Visitors W observers present <br /> during test etc <br /> Tests were made on the above tank systems on accordance with test`procedures prescribed for PETRO--TITE <br /> 2. TEST RESULTS as detailed on attached test Charts with results as follows: AI <br /> Tans Iden!.f:ca!,on TrgMt leakage Intbcatto Daft Tested - <br /> ')— - — — <br /> _ <br /> This is to cenity that thesa tank systems were tested on the date($)shown.Those indicated a®"Tight'mfrot the criteria establishead by <br /> 3. CERTIFICATION tete Nation. ire Protection Asociatron pamphlet 329. <br /> 2-6-91 Cil.kMPION'-S .PRECISION TANK TESTING <br /> r POr-. Box 1309 �R��i�c T n TO ay CA. �stdna„r�8 13-3059" 2 <br /> , <br /> Se'J+NO eu thermic fe nnu+ant -. -- AgOr•ts �... <br />