COMPLIANCE INFO_1995-2006 - Laserfiche WebLink

Home Browse Search

car Tight ® S I T E I N F O R M A T I O N F 0 R M Inoculation State Technician :� ` Ma�or�ot IDD rTight�l ��pyb License # : 03-1641" Tracer Job 9(0®ZO-6-Sampling�AOAS TracerTight®/1051 State 1"3-/tR43 Technician % ID License Precision Test ❑ Leak Delineation ❑Depth ® Affilliate h;{� "� Vlf� 1 Site Name t} cj'A�rY C�K:UYt1 �� Site Address -� dud XYA City koCXka ` State : GA Zip :R 510L 10 3 Precision Test ❑ Leak Delineation ❑Depth Inoculation date , /O to ground water in tank pit inoculation/initial inches): 7F0 in. Initial Test ❑ All Water Ingress ❑ 10 3 at visit (in Sampling / �n / /1 2 Depth to ground water in tank pit o/ // at sampling/second visit (in inches): (+O in. (see box at right) Annual Test ® MonthlyMonitoring g ❑ date tX 03 / To be used for ALL Water Ingress Tests Retest Result Verification ❑ Maximum Sample Vacuum Tank(s) were constantly & completely ❑ a submerged in water for the F-1 Residential Tank(s) ❑ (Highest probe Vacuum on site) in Hg ground duration of the test . YES NO L At inoculation At sampling poo n m oy na+ ou °° level in tank Total Lui level H O level n itank TotaLuidd level Tank No. Product o w®t0 Volume (in gallons) y "H a n w 0pc n? S� o a xi m o a 4; a r a w h in inches) (in inches (in inches) (in inches o tr®p o t lam° poo X1� O/ O Y. NO US NO<71 q0 NO NO 3 UN L ®� 1 1 X32, Ea IQy� \ 1�1.0 4� S ' NO NO i 711 ❑ 1:1 C1 1:1 1:1 El YES NO TW NO YES NO ❑❑ ❑ ❑ ❑ ❑ YES NO YES NO YES NO ❑ ❑ ❑ ❑ ❑ ❑ YES NO YES NO YES NO ❑ ❑ ❑ ❑ ❑ ❑ YES NO YES NO YES NO D ❑ ❑ ❑ ❑ ❑ ITS NO ME NO YES NO Comments :-------------------------------------------------- Revised 8-27-98 Rev. 03 Tracer RC S t i l C 6 CBI ®D / i i/ O D