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AFFORDA-TE$T 416 2nd Street Gait CA 95632 Spill Bucket <br /> (209) 744-0112 (209) 744-0116 FAX Test Report <br /> TEST DATE <br /> 4 <br /> SITE NAME 1, PHONE <br /> ADDRESS 4� <br /> CONTACT: <br /> Inspector: tLa Present Not Present <br /> 3. SPELL BUCKET TESTING INFORMATION <br /> Test Method Used: 0 Hydrostatic 0 Vacuum 0 Other <br /> Test Equipment Used: Equipment Resolution: <br /> Identify Spill Bucket(By Tank 1 2 .3 4 <br /> Number,Stored Product, eLc.)— <br /> Bucket Installation Type: >kDirect Bury 0 Direct Bury 0 Direct Bury 0 Direct Bury <br /> -0 Contained in S 0 Contained in S DC' ontained in Sump 0 Contained in Sump <br /> Bucket Diameter: <br /> Bucket Depth: <br /> Wait time between applying <br /> vacuum/water and start of test: <br /> Test Start Time(Ti): <br /> Initial Reading(111): 7 7A_ <br /> Test End Time(Tp): <br /> Final Reading(RF)- <br /> Test Duration(TF-T)- <br /> -Change in Reading(RF-R): <br /> Pass/Fail Threshold or <br /> Criteria: <br /> 31 <br /> Comments (include information repairs made prior to testing, and recommended follow-up for failed tests) <br /> Test Water: F]Taken with tester Left 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: Lyle D. Nimmo <br /> [CC 5249115-UT <br /> Signature: JA41AYIA OTTL#: 97-1143 <br />