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♦' 0wo: Site* <br />MONITOR <br />- a <br />................. <br />........ ......... <br />. . . . . . . . . . . . . . . . .tel . . . . . .. <br />........... <br />s <br />. . . . . . . . C a ze . . . . . . . <br />. . . . . . . . . . . . . . . . . <br />0.2 <br />.. ... <br />................................. <br />.. <br />................ <br />.......... ........ <br />Vapor Recovery System & Vents were tested tank? <br />arts and Labor used <br />eneral Comments <br />Standard Symbols for diagram below <br />(DFill <br />Vapor Recovery <br />V.R. w / Ball Float©Monitor <br />Well <br />O <br />Observation Well <br />O Ball Fl•a <br />4 <br />(OutsideTank Gauge <br />TIME <br />M ManwayaIron <br />T <br />- a <br />................. <br />........ ......... <br />. . . . . . . . . . . . . . . . .tel . . . . . .. <br />........... <br />s <br />. . . . . . . . C a ze . . . . . . . <br />. . . . . . . . . . . . . . . . . <br />0.2 <br />.. ... <br />................................. <br />.. <br />................ <br />.......... ........ <br />Vapor Recovery System & Vents were tested tank? <br />arts and Labor used <br />eneral Comments <br />.s <br />When OWNER or local regulations require immediate reports of system failure -Complete the following: <br />REPORTED <br />NAME <br />DATE <br />TIME <br />T <br />Phone# OWNER or Regulatory Agency <br />FILE NUMBER, <br />V <br />Prank Certs ed Testers Name <br />Vacuiec cation Number <br />., g <br />Certified Testers Signa <br />Date Testing Completed <br />_ , Fonn- <br />