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Identity by Direction <br />Capacity <br />Brand/Supplier <br />Grade <br />Approx. Age <br />Steel/Fiberglass <br />5. TANK INVOLVED Nos r;, <br />O <br />t _� ��.��7 tl <br />R , r <br />ANIL <br />A <br />1.".` ��/9L� <br />Data Chart for Tank System Tightness <br />Test' <br />A ar°v/ <br />Use additional lines <br />for manifolded tanks <br />v <br />PLEASE PRINT <br />Location <br />1. OWNER Property❑ <br />Beacon <br />Oil Company <br />525 W. Third Street <br />Hanford, Ca. 93230 <br />583=3214 <br />Tanks) ❑ <br />9eacon <br />Oil Company <br />525 1�°." <br />�,t�Ithird Street <br />Hanforr1e;`a`1a. 93230 <br />TJOT2'�214 <br />Concrete, Black Top, <br />Earth, etc. <br />Namf <br />Size. Manifolded <br />Address <br />Representative <br />Telephone <br />2. OPERATOR <br />Beacon <br />4513 401 <br />W. Kettleman Lane <br />Lode, Ca. 369-1525 <br />Name <br />Address <br />Telephone <br />3. REASON FOR <br />TEST <br />To test system for <br />tightness <br />(Explain Fully) <br />4. WHO REQUESTED <br />Julie Caldwell <br />6/9/89 <br />TEST AND WHEN <br />$leacon <br />Oil Company <br />525TW. Third Street <br />°oat n`f`"olr�'; Ca. 93230 5EI 3214 <br />Address <br />Teleohone <br />Identity by Direction <br />Capacity <br />Brand/Supplier <br />Grade <br />Approx. Age <br />Steel/Fiberglass <br />5. TANK INVOLVED Nos r;, <br />O <br />t _� ��.��7 tl <br />R , r <br />U ACYZI1, ort <br />r2• DC% <br />1.".` ��/9L� <br />PrP <br />A ar°v/ <br />Use additional lines <br />for manifolded tanks <br />v <br />Location <br />Cover <br />Fills <br />Vents <br />Siphons <br />Pumps eh D re <br />6. INSTALLATION So cr4 <br />DATA �rv�N1'®F 5roll <br />Oo K osw `P <br />3 —G/ <br />3 - <br />9,0,5.*/ P-4 <br />North inside driveway, <br />Rear of station. etc. <br />Concrete, Black Top, <br />Earth, etc. <br />Size. Titehli make, Drop <br />tuba. Remote Fills <br />Size. Manifolded <br />Which tanks? <br />Suction, Remote, <br />Make it known <br />/. UrvUtHVHUUNU <br />WATER <br />8. FILL -UP <br />ARRANGEMENTS <br />9. CONTRACTOR, <br />MECHANICS, <br />any other contractor <br />involved <br />10. OTHER <br />INFORMATION <br />OR REMARKS <br />Depth to the water table <br />Tanks to be filled hr. Date Arranged by <br />Extra product to 'top otr and run tank tater. How and who to provide? Consider NO Lead. <br />Terminal or other contact <br />for notice or ino..m <br />Is the water over the tank? <br />L_1 Ya C�l No <br />Name <br />Company Name <br />Telephone <br />Telephone <br />LAdnal information on any items above. Officials or others to be advised when testing is in progress or completed. Visitors or observers present during teat. etc. <br />11. TEST RESULTS sa were made nthaetdlb onnaatttac ads �tcharts w�rt ts an fa d"re' Pr°"rsbed for <br />dentification Tight Leakage Indicated Date Tested <br />No y -A <br />GN* A L` ®P I. .... <br />I.c !-ie VZL,r acs1O -/3 -S19 <br />12. SENSOR - 13. This Is to oMny that these talc system was acted on the p sholivin. Those Indicated as " Nhr meet the attMat fartablilshed by the <br />CERTIFICATION Nallignal A"' PTDa`tl°" Assocladon Parngtae 3M <br />84 Technicians/«� a'3 ,GQoo��,�f' �%pl,.�vuo(� Li uid Construction, Inc. <br />,;75! 17A 7Testing Contractor a Company. By: Signature <br />-04"No. ofThermal con cado, L/<<! �!/G 3%L _ P.O. Box 1220 Tulare, C.a. 93275 <br />Sat, <br />Address <br />z <br />' F Cartiflcatlon • - _ <br />tp ".4m"::! WIN .7.. +:I`: ._.._. "M <br />