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P.O. Box 13059 <br /> Champion Sacramento. CA 95813-3059 <br /> Precision Tank Testing CA 800-660-9443 <br /> License No. 73848 NEV 800-949-9443 <br /> (916) 927-1557 <br /> Fax: (916) 927-7345 <br /> -HORNER EZY-CHECK CERTIFICATION <br /> Property <br /> Owner: <br /> Address: 4 ow Y-b ,J CA <br /> Tank Address: 303 C-0 D <br /> *Notice to owner(s)* A copy of this test result has been filed with the proper regulatory <br /> agency. It is the responsibility of the owner(s) to contact the local Env. Health Dept. in <br /> his or her area of any tank failure within (24) hours of testing. <br /> Tank# Product Capacity Apx. Age Steel Fiberglass Supplier <br /> (IV ftr-'F 0 1 0 <br /> L <br /> Tank( s ) were filled on: Distributor: ocolra-?t <br /> Date Time <br /> Extra product to top off:_No[-I'Yes[ ] Gallons <br /> Comments : <br /> TEST RESULTS INCLUDE <br /> Tank( s ) Product Line(s)_ Vapor Recovery System_ Vent Line(s )_ <br /> Tank Tight Tight Leak indicated Leak indicated Date of <br /> ID# Tank(s) Line(2) per hr. ( tank) per hr. ( line) testing <br /> Yes[;f&'o[ ]Yes[ ]No[ ] 4.00 <br /> Yes[ ]No[ ]Yes[ ]No[ ] <br /> Yes[ ]No[ ]Yes[ ]No[ ] <br /> Yes[ ]No[ ]Yes[ ]No[ ] <br /> Yes[ ]No[ ]Yes[ ]No[ ] <br /> Yes[ ]No[ ]Yes[ ]No[ ] <br /> Technician: License # : <br />