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Rp7 ,07 14 10: 12a Elite IV Contactors 12094616342 p. 4 <br /> MOIL <br /> AV. <br /> SWRCB,January 2006 <br /> piU Bucket-Testing.Report F, rm; <br /> Thrsform is intended for use by corziraetcux performIng annual fafing of USTsin co; 'amment structures..The rompleted'form and <br /> ,printouts from rests(tf applicable);should be provided to the facahty vtivnerloperato�fi ;submittal to the local regulatory agency. <br /> I. F•AC ITY MFORMATION.. <br /> Facility.Address: . <br /> L Lte mf Testing. 3. <br /> Facility Gmtac Phone;,;!, (• fi?. "! <br /> _lie Toca t Agete yWas Noeti of T'estiiag <br /> 'N8lT1C OgTACaF A enC - <br /> g y InspectarCfpresent_drrt fng tesrirrg):- ._ a <br /> 2.: TESMG.CONM&OR lwolnfll <br /> Cowp=y <br /> Technician Conducting Test: – <br /> Cre o CSLB C•on ractorCC Service Tech ❑SWRCB Tssxak Testet . tJ Other{Specify) <br /> • <br /> SPILL J3UCUT. .•TE G TJ:f <br /> Test Method Used: static p Vag la C her <br /> TestEgnipmentUscd: .F7 ;pm&iResohationi. <br /> Mortify SpiEE Bucket*'Truck 1. 2 3 q <br /> 'Number,Stored Product;ete <br /> Installation Type: B O:Direct$ury 0 E rest Bury 0 Direct B <br /> 0 Cbatiftied in 0 Conh&wd in LUMG G ntained in S '0 Contained in <br /> t Diameter. <br /> Bnckct DeptkMLL- <br /> 1 <br /> �'Vait time between applying <br /> vacawntwater and start oftest: <br /> Test.Stat T_i . . ' APR' 2014 <br /> _ . <br /> Initial Reading(Raj: – <br /> Test End Tirs6,(Tr): <br /> Final Reading(Rgj: _ .. <br /> ...Tt�tDcttation:{TF–Taj:. – •• • . '. • <br /> Chanip <br /> -in Reading 04-N: <br /> P&"Mi rg Threshold or <br /> Q C1ALS,=(include infcrr?natinn nix rr paha made prior to!�siing,acrd recontmend6 f,illo Lup for failed tests. <br /> CERTM OF TMCMUCLAN RESPONSIBLE FOR CONDUC ZNG THISIESMG . - <br /> contained.ire;d*repost iss true,accurate,.w4 Pn Full compAwe with.legal re <br /> Ihereby. fy that atl the.inferrruatlnitr: <br /> Techaeician's.Sigaa4ure• s� 7 <br /> : • <br /> A;State lawsaid=r taotrs do iiot'cuarently mgdire.testing to-be-pe famed by a u atraet+or~-However local=r is <br /> may be more stringent: <br />