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e` <br />AFFORDA-TE$T 416 2nd Street Galt CA 95632 <br />(209) 744-0112 (209) 744-0116 FA; <br />Spill. <br />Test Report <br />TEST DATE <br />• • �. - • <br />:SITE NAME <br />ADDRESS <br />- s. <br />M�� <br />OW -1911M all, I 11MINl <br />Bucket Diameter: <br />Bucket Depth: <br />Wait time between applying <br />vacuum/water and start of test: <br />Test Start Time (TO: 0 pp <br />Initial Reading (RO:` 11 <br />Test End Time (TF): 00 <br />Final Reading (RF): <br />Test Duration (TF — TI): Vinur <br />Change in Reading (RF - RO: <br />Pass/Fail Threshold or <br />Criteria: <br />Comments.—. (include information on repairs made <br />/ Not Present <br />and recommended follow-up for fail <br />Test Water: ❑Taken with tester Lefton 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. Nimmo <br />- ICC #: 5263322 -UT <br />Signature: OTTL #: 04-1676 <br />