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rasp 'Tank Testin & Construction pang. <br />ow w <br />Phone (209) 931-1828 <br />,Post Office Box 30487 OCT 2 3 1992 Licensed <br />Insured <br />Stockton, California 95243 ENVI ONMENT L HEALTH LICENSE 2-124 <br />PER ITA,WQEPORT** LEONARD E. CRISP <br />OWNER OF SITE• <br />ADDRESS: CITY:T, 6j4 ZIP <br />OWNER OF TANKS:_ ---yi-/� <br />ADDRESS: CITY: ZIP: <br />OPERATOR AT LOC�AT/ION: %�(/,�'� &el� /7 l <br />ADDRESS: �%L /i(l YGb i�/7�" CITY: 1-1w % ,ex ZIP: <br />COUNTY : ��k TANK # : _�_AGE: GALLONS: <br />METAL(.y) FIBERGLASS( ) SINGLE WALLED( ) //DOUBLE WALLED( ) <br />DIESEL( ) UNLEADED( ) PREIKIUM UNLEADED( <br />WASTE OIL( ) KEROSENE( ) AVIA'T'ION GAS( ) JFT FUEL( ) WATER( ) <br />,SUCTION( ) SUBMERSIBLE(X) OVERSPILL, CONTAINER--YES( ) NO(XJ <br />SHEAR`'VALVE--YES(N NO( ) IN-Li NE LEAK DETECTOR--YES( ) NO(<) <br />VAPOR RECOVERY SYSTEM --YES(}( NO( ) *LF YES, PITASE 1(X) PHASE 2(�() <br />TANK FILL DATE :-2 '92- TIME: 200C> <br />TANK TEST DATE: 6"Z-6'g2 START : 0730 END'__Q9,30 LENGTH OF TEST: 2 -Ilks • <br />TANK BOTTOM TO GRADE... % �! TEST LEVEL TO TANK BOTTOM 160 <br />TANK TOP TO GRADE ....... GROUND WATER ABOVE TANK.. �D- <br />DIAMETER................ PSI..................... .026 <br />TEST LEVEL ABOVE GROUND. <br />NET TEST PRESSURE........ 4.16 <br />WATER IN TANK.......... -8— API SPEC GRAV...........'%;� <br />DEPTH FOR TAKING SAMPLE. .j 'TEMP.................... <br />TEMPERATURE PROBE DEPTH API SPEC GRAV C 60' F.... <br />COEFICIEN'T OF EXP........p� ,.,((„ 7 <br />CERTIFIED TIGHT--YES(X) NO( ) LEAK RATE PER/HR:+ <br />PRODUCT LINE TEST--PASS( ) FAIL( ) SUC'T'ION( ) PRESSURE( ) <br />CERTIFIED TIGHT- =YES( ) NO( ) LEAK RATE PER/ITR:-+- /- <br />DATE:_ SIGNATURE OF `I'ES'TI'sR,l <br />COMMENTS: <br />REV 3/92 <br />