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416 2nd Street Galt CA 95632 11 et <br /> AFFORDA® (209) 744-0112 (209) 744-0116 FAX <br /> Test Report <br /> TEST DATE Z 5 d <br /> SITE NAME PHONE )3 - <br /> ADDRESS a- Bei) CONTACT: -3/", <br /> , <br /> 1,6a, ca <br /> Inspector: Present / Not Pre <br /> 3 SPILL BUCKET TESTING INFORMATION <br /> Test Method Used: Hydrostatic. 0 Vacuum 0 Other <br /> Test Equipment.Used: AP Equipment Resolution: <br /> Identify Spill Bucket(By Tank 1Q 2 8� 3 q 4 <br /> Number,Stored Product, etc. U <br /> Bucket Installation Type: Direct Bury Direct Bury irect Bury 0 Direct Bury <br /> 0 Contained in Sump D Contained in S 0 Contained in Sump 0 Contained in Sump <br /> Bucket Diameter: <br /> Bucket Depth: , - 1 <br /> Wait time between applying <br /> vacuum/water and start of test: <br /> Test Start Time(TO: 1415 <br /> Initial Reading(R4): <br /> Test End Time(TF): I AS15I <br /> Final Reading(RF): - <br /> Test Duration(TF-Tj): <br /> Change in Reading(RF-IQ: <br /> Pass,Tail Threshold or <br /> Crit a: <br /> Comments-(include inform ati n n repairs made prior t6 esting, and recommen e follow-up for failed tests). <br /> Test Water: Taken with tester [:]Lefton site <br /> I hereby certify that all the information contained in this report is true, <br /> accurate, and in full compli nce gal requirements. Technicians , Zane A. Nimmo <br /> ICC#: 5263322-UT <br /> Signature: OTTL#: 04-1676 <br />