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Apr 15 05 11:27a <br />SWRCB, January .2002 <br />Af 19da-Test <br />Faoili is Not Equipped With S iil/overfill Containment Boxes ❑ <br />Spill/Overfill Containment Boxes are 1'rescnt, but were NotTcsted ❑ <br />Test Method Developed By: Cl Spill Bucket Manufacturer �t'y <br />❑ Other (Spes6) <br />Test Method Used: 0 Pressure ❑ Vacuum <br />❑ Otbar (Specify) <br />Test Equipment Used: � <br />spill Box # J Spill sox # <br />Bucket Diameter: <br />Bucket Depth: <br />pressur&vacuum/water and <br />Test Start Time' . <br />initial Reading (R,): <br />Tes End Time: <br />Fi:aal heading (Rr)'. <br />Test Duration: <br />Change in Roading (Rt <br />Pass/Fail Tintshold or <br />rn <br />r <br />l <br />120 84-0112 p.9 <br />Page <br />AES <br />Standard ❑ Professional Engineer <br />d" <br />Box # <br />IIIIIII-OFM <br />Please direct any comments regarding this form to: <br />SWRCB UST Program, Attn: Scott Bacon <br />100 1 " ' Street, Box 944212 <br />Sacraments, CA 95814 <br />Phone: (916) 341-5873, Fw. (916) 341-5808 <br />e-mail: bacon4cvvp.swrcb.ca.90v <br />