Laserfiche WebLink
Dataftart for Tank System T1#&ess Test <br />t <br />petro ILfe <br />PLEASE PRINT TANK TESTER <br />1. OWNER Property <br />Q Nama <br />Tank(?) <br />Nam• <br />2. OPERATOR EACo•v a 6 /Z/0 E LN• To XTO.- cA. ZO -1177- <br />him. Add—. TO.oho"• <br />3. REASON FOR f1/•�/> <br />TEST <br />(Explain Fully) <br />4. WHO REQUESTED <br />TEST AND WHEN "'m' <br />5. WHO IS PAYING <br />C°mpa"*• Agency Dr <br />FOR THIS TEST? <br />n0o.•s, <br />Ada—$ <br />aleahenr <br />•IeDnO"• <br />wadress <br />Lomoany or And.auon <br />Nepnoe• <br />10. CONTRACTOR. <br />MECHANICS, <br />any other contractor <br />involved - <br />1 <br />OTHER <br />INFORMATION <br />OR REMARKS <br />i <br />Additional anlormat.on on any items above. Officials or others to be advised when testing is in progress or completed. Visitors or observers preseni <br />during test etc. <br />Billing Add, 11 <br />Tests were made on the above tank systems in accordance with test procedures Prescribed for <br />City <br />12. TEST RESULTS <br />stria <br />Zi0 <br />Tank Identification I Tight I leakage Indicated <br />Attention OI: <br />IPE v[ R 7-/6H7- t•O 7 G H. <br />Order No. <br />Other Inr,tuCtionr <br />�2 <br />tJ-✓L£ADE TIGHT -- 009 G.P f/ <br />/Z Z-uLYSS <br />Identity by Direction <br />Capacity <br />Stand/Supplier <br />Grade <br />Approx. Age <br />'I <br />Steel/Fiberglass <br />6. <br />TANK(S) INVOLVED <br />FAST or <br />FOV,P <br />/0,000 <br />BEAC0../ <br />REIS,uL.4R <br />EAS MIDDLE <br />/p 000 <br />BEACO•t/ <br />�Z vn/LEADEI, <br />WES/ODLE <br />'`ZIO:2100 <br />B�i4C_'v <br />PiPEMIUM "All <br />Location <br />Cover <br />Fills <br />Vents <br />Siphones <br />Pumps <br />7. <br />INSTALLATION <br />So" Tr/ SIDE <br />R! /M0 L <br />DATA <br />o F S rsf T/O.✓ <br />C O. �C.4ETE <br />1 7H <br />y t r D ROP <br />3✓p <br />T.O K r=r'E/-I'll <br />>u3E <br />North Inside driveway. <br />Concrete. Black Too. <br />Sit.. Thirtill make. Drop <br />Suction. Atmore. <br />'teat of sea Pon• etc. <br />Earth. sit. <br />tubes. Ren.ote Ails <br />Site. Menilolded <br />which tanks? <br />Make it kno— <br />8. <br />UNDERGROUNDIs <br />the water over the lank? <br />WATER - <br />Depth to the Water table } <br />Yes <br />® No <br />Tanks to be filled <br />hr. <br />Date Arranged by <br />9. <br />FILL -UP <br />Name <br />TeteDhen< <br />ARRANGEMENTS <br />Extra product to "top oil'• <br />and run TM. How <br />and who to provide? <br />Consider NO Lead. <br />. <br />Terminal or other contact <br />— <br />- <br />lot notice or inQuiry <br />- <br />Company <br />Name i. <br />Terfphpne <br />10. CONTRACTOR. <br />MECHANICS, <br />any other contractor <br />involved - <br />1 <br />OTHER <br />INFORMATION <br />OR REMARKS <br />i <br />Additional anlormat.on on any items above. Officials or others to be advised when testing is in progress or completed. Visitors or observers preseni <br />during test etc. <br />Tests were made on the above tank systems in accordance with test procedures Prescribed for <br />PrlrO TI P <br />12. TEST RESULTS <br />as detailed on attached test Chans with results a$ follows: <br />" 104; <br />Tank Identification I Tight I leakage Indicated <br />( Date Tested <br />IPE v[ R 7-/6H7- t•O 7 G H. <br />JZ SuL 88 <br />�2 <br />tJ-✓L£ADE TIGHT -- 009 G.P f/ <br />/Z Z-uLYSS <br />"Z- Ljyi HOED 7'/&A/7— f 0/9• G -F•N• <br />!z Z-uLY88 <br />P E.a9rvM UA11_etDEO T/VNT G•PN• <br />/L-TULYSS <br />13. CERTIFICATION the <br />6 - 3o - 90 <br />REG —x932 V•a <br />'�syz -/'�/3 Pf?E.arwrl-/S� <br />This Is to cenity that these tank systems were lested on the date(s) shown. Those Indicated as "Tight- meet the criteria established by <br />National Fire Protection Asoctation Pamphlet 329. <br />MAR K _5'4'A x/ BEC KFP /t/DE15TR <br />lawno co.—cm. or ca."••y. ay: Se•aw.. <br />RODNEY F}u,PFifr�D ZSo / oil K �T. �/APi9, CA. 9 ySS`I <br />S.nef NO. of The..nat <br />S.nso <br />Iecn...c.,n, Aee.••• <br />