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r <br />OfispJank 1"Sting & ConstruclOn Company <br />Phone (209) 931-1828 - Licensed <br />Post Office Box 30487 Insured <br />Slocidon, California 95213 LICENSE`- _ _ , <br />**TEST REPORT** LECvA. - rae`` <br />s <br />OWNER OF SITE: - -- <br />ADDRESS: . •.. IT ZIP <br />OWNER OF TANKS: S @ - <br />ADDRESS: CITY: —I—ZIP: <br />OPERATOR AT LOCATION: I' <br />ADDRESS: c a CITY: C c'3 ZIP; <br />COUNTY : TANK #: AGE: Z6 GALLONS : M. _ <br />METAL( -s/) FIBERGLASS( ) SINGLE WALLED k) DOUBLE WALLED( ) <br />DIESEL( ) UNLEADED( ) PREMIUM UNLEADED(Y-) ( } <br />WASTE OIL( ) KEROSENE( ) AVIATION GAS( ) JET FUEL( ) WATER( ) <br />SUCTION( ) SUBMERSIBLE(Y-) OVERSPILL CONTAINER--YES(Z.) NO( ) <br />SHEAR17VALVE--YES( NO( ) IN-LINE LEAK DETECTOR--YES(K) NO( ) <br />VAPOR RECOVERY SYSTEM--YES(dO NO( ) *IF YES, PHASE 1(b-) PHASE 2(1,) <br />TANK FILL DATE: 'TIME: <br />TANK TEST DATE: 2 START : END: i LENGTH OF TEST: =% <br />TANK BOTTOM TO GRADE.... TEST LEVEL TO TANK BOTTOM LLt_ <br />TANK TOP TO GRADE....... i1 GROUND WA'T'ER ABOVE TANK.. <br />DIAMETER ................ 9iP PSI...... j............... <br />TEST LEVEL ABOVE GROUND. NET TEST PRESSURE........ <br />WATER IN TANK.......... . API SPEC GRAY............ <br />DEPTH FOR TAKING SAMPLE._ &0" TEMP .................... <br />TEMPERATURE PROBE DEPTH. APF SPEC GRAY C 60' F.... <br />• COEFICIENT OF EXP........ k <br />``//`` <br />CERTIFIED TIGHT--YES(V+ NO( ) LEAK RATE PER/11R:+ <br />PRODUCT LINE TEST--PASS('q FAIL( ) SUCTION( ) PRESSURE(50 <br />CERTIFIED TIGHT--YES(-i NO( ) LEAK RATE <br />COMMENTS: <br />µS <br />DATE: -' SIGNATURE OF TEST Ewtz)v'0_0n4',1ty <br />REV 3/92 <br />1 <br />