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Data Chart for Tank System Tightness Test <br />V4- <br />4 - <br />PLEASE PRINT <br />1. OWNER property❑ <br />Tank (s) ❑Be <br />Beacon Oil Company <br />525 W. Third Street Hanford, <br />Ca. 93230 <br />Name Adtlress Representative <br />et Hanford <br />Tolson no <br />Ca. 93230 <br />Name Address Representative <br />Telephone <br />2. OPERATOR <br />1210 <br />E. Hammer lane Stockton, Ca. <br />477-3111 <br />Name Address <br />Telephone <br />3. REASON FOR <br />TEST <br />(Explain Fully) <br />To test system for tightness <br />4. WHO REQUESTED <br />TEST AND WHEN <br />Julie Caldwell <br />6/21/89 <br />Name Title Company or Affiliation <br />Beacon Oil Company 525 W. Third Street Hanford, <br />Date <br />Ca. 93230 <br />Address <br />Telephone <br />5. TANK INVOLVED <br />Use additional lines <br />for manifolded tanks <br />Identity by Direction <br />1 5 c a <br />Capacity <br />to 9C, 0 <br />Brand/Supplier <br />N /< .. <br />Grade <br />a <br />Approx. Age <br />Steel/Fberglaw <br />%— < ,i — ti C � N7 <br />L/ N <br />i en <br />ovr-t, 04071— <br />Q9 0 <br />0 At KAf <br />I/ N `.cu AC <br />n <br />Tv e I <br />.0 -If tvv P r4, <br />l <br />V u 14Ar e 60 <br />9< o t c <br />U &I X0qr,-7") <br />'.ie e C --' <br />6. INSTALLATION <br />DATA <br />Location <br />WQ5ill" oG <br />STv f e <br />North inside driveway, <br />Rear of station, etc. <br />Cover <br />Cor1-Gr el c <br />Concrete, Black Top. <br />Earth, etc. <br />Fills <br />f�_r♦ rr <br />Size, Titelfill make, Drop <br />tubes, Remote Filo <br />Vents <br />3 _moi <br />Size. Manifoldetl <br />Siphones <br />Yvoivc <br />Which tanks? <br />Pumps At! *0%�r_ <br />/,c/gyir F <br />Suction, Remote. <br />Make if known <br />7. UNDERGROUND <br />WATER <br />Depth to the Water table �! o w <br />Is thew water over the tank? <br />G U yes ONO <br />8. FILL -UP <br />ARRANGEMENTS <br />Tanks to be filled hr. Date Arranged by <br />Name <br />Extra product to 'top off" and run tank tester. How and who t0 provide? Consider NO Lead. <br />Telephone <br />Terminal or other contact <br />for notice or inquiry <br />Company Name <br />Telephone <br />9. CONTRACTOR, <br />MECHANICS, <br />any other contractor <br />involved <br />10. OTHER <br />INFORMATION <br />OR REMARKS <br />information an any items above. Officials or others to be advised when testing is in progress or completed. Visitors or observers present during test. etc. <br />11. TEST RESULTS <br />rAdnal <br />sts were made on the above tank systems to accordance with test procedures prescribed for <br />as detailed on attached test charts with results as follows: <br />Tight Leakage Indicated Date Tested <br />Identification <br />ttl o u G e P -f 009 <br />t_3 N o 12-A ,, _,01-7 51 <br />tritt Nof-9 <br />12. SENSOR <br />CERTIFICATION <br />y -}/-Q9 <br />13. Tit's Is to all" that these tartk systeea were tested an cite date(s) shown. Those Indicated as 'T%hr meat the aARes establisind by the <br />Nanonat tan Probetion Amodation Psmphist 32S - --- - -- — _ -- <br />TelxwtfClana <br />Dat. ,tr}, ,. G sort's. �/g�hroaeL Liquid Construction, Inc. S �%�/-/Jug -�s'Y✓ <br />no�dT Tasting Contractor or Company. By: Slgnstu <br />A2SonalNo. ofTheT�� CeMncahona1/43A P.O. Box 1220 Tulare, Ca. 93230 <br />`13 Sensor U Addreas <br />)-727 � Z <br />Certification e <br />"R <br />rte. .,' ."�'`•7 �+', a;?'7- <br />,..a..��'. ky 7:'� <br />