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' <br />6. INSTALLATION <br />DATA <br />location Cover Fills Vents Siphon« <br />17c2t t4 k'R� I/� <br />a F C0,7 e- atF i I,- t� /� <br />S To(t?T `� �� <br />Sacramento Equipment Maintenance Company Inc - <br />7. UNDERGROUND <br />WATER <br />North Insiden. ConeTop, tixe. �byS'Reaofn Earth. Na Wb«Ramot fill Fr We. ManitoWadWhich LNca9 <br />left.a,erov«nwtermk? <br />Depth to the water two Abn;Tr to W P(t ( f'YJ RN /o0 ❑ r« 15INo <br />2533 Connie Drive.,, - <br />� <br />Tanks to be ailed hr. Data Anarped M <br />. <br />Sacramento, CA 95815 <br />. ._ � , <br />`• - • <br />Calif. Corals. License N502377 <br />_(916) 925-2716 .. _:: �.-_ . <br />` wo i <br />56752 <br />PLI?ASEPIUNT <br />Data Chart for Tank Systemlightness <br />Test <br />9. CONTRACTOR. <br />MECHANICS, <br />3 1192 <br />1 OWNER .. O _ <br />BP Oi 1 Coma -_2868 Prospect <br />, - x <br />ParkKDrive ��Suite <br />60 <br />Tankp) <br />C0 M5670 <br />� <br />Lou <br />T <br />.. .. -W--------- <br />Issrtms <br />Par — <br />— <br />r <br />F` <br />- Address <br />1—l" ... pa0raaaMNM __ . <br />.. Telephone, <br />- 4 _2pg2 <br />s -- 2, OPERATOR - �-_- <br />BP-,-- «C <br />'-14 ount . Club Blvd. - <br />Aae rw <br />Stockton, -rCA1l20 <br />3. REASON FOR "r <br />Count 'Permits <br />.. - <br />Tetavtrona <br />` TEST <br />r <br />wis oo r r <br />n <br />(Explain Fully) <br />4 WHO.REQUESTED <br />TESTAND WHEN <br />Dema ., , ..,x .. - Tale <br />Company or Afliltetbn <br />oKa <br />Address <br />Telephone <br />5. TANK INVOLVED <br />Wsntln by Dir«tbn -... <br />capacity <br />Brond/Supplier <br />Grads <br />Approx. Age <br />__. .. <br />st«VFibergle« <br />o <br />the additional Ines <br />for atanftk ed Ionics <br />O .Ob n <br />t3 . <br />c A" .0 <br />_ <br />' <br />6. INSTALLATION <br />DATA <br />location Cover Fills Vents Siphon« <br />17c2t t4 k'R� I/� <br />a F C0,7 e- atF i I,- t� /� <br />S To(t?T `� �� <br />Pumps <br />R'T /0 <br />SAcKr' i <br />7. UNDERGROUND <br />WATER <br />North Insiden. ConeTop, tixe. �byS'Reaofn Earth. Na Wb«Ramot fill Fr We. ManitoWadWhich LNca9 <br />left.a,erov«nwtermk? <br />Depth to the water two Abn;Tr to W P(t ( f'YJ RN /o0 ❑ r« 15INo <br />f <br />Wks auction. <br />8. FILL -UP <br />Tanks to be ailed hr. Data Anarped M <br />ARRANGEMENTS <br />Esirs product to lop off' and tun tank tester. Now and whe to provide? Consider NO Lead Nerve <br />Tslephons <br />Terminal or other contact <br />for noun or kpuiry <br />. <br />Company Name <br />TNso wme <br />9. CONTRACTOR. <br />MECHANICS, <br />any Otter contractor <br />Invoked <br />10. OTHER <br />INFORMATION <br />OR REMARKS <br />T % ,' 05 11Z a <br />Additional inbmstion on any items above. Omolets or other to he advlesd when setting Is in pMmu or completed. Visltots or observers presm aft t«t. etc. , <br />11. TEST RESULTS <br />Tests were made on the above tank systems in accordance with test procedures prescribed for as detailed on attached test charts with results as follows: <br />i49 <br />Tank IdenaOoation Tight L"Upa Indicated Oats In <br />o a ►( v <br />wis oo r r <br />12. SENSOR - <br />CERTIFICATION <br />two <br />8eriai No. Of Thermal <br />Sensor <br />13. This Is to certify that these tank systems were tested on the date(s) shown. Those Indicated as •'Tight'• meet the criteria established by <br />the National Fire Protection Association Pamphlet 329. <br />Ted the h is the responsibility of the owner and /or operator of this tem to Immediately � system ttmeriatsy advise state and kx:al authorities of any <br />��, ,,.� - /n �,y/► implied hazard and the possibility of any reportable pollution to the envkoraasra as a result of the indicated failure of this <br />system. Heath Consultants Incorporated and/or SACRAMENTO EQUIPMENT MAINTENANCE COMPANY, INC. does not <br />assume any responsibility or liability for any loss of product to the environment. <br />CeAlaaaon a k` [ nI-A[n-T( Tank Owner/Operator v <br />01 <br />