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' Afforda Test <br /> OVERFILL WORKSHEET <br /> t <br /> Facility Name : e ; `T rQe- kri ,,A INFORMATIONAL ONLY " <br /> Facility .Address : <br /> Facility Contact: <br /> OVERFILLS : 4-5 - 19- <br /> Tank <br /> - -Tank Charts Used : Xerxes <br /> 1 . TANK INFORMATION <br /> Tank Chart Tank Manufacturer ! Industry Standard Chart <br /> kI r I - . . <br /> { R Tank # 1 Tank # 2 Tank # 3Tank #4 Tank `E5 Tank #6 <br /> -- <br /> /' /gZ 1 ! 692 <br /> 1I Tank Capacity: <br /> Tank Material : <br /> 41 Tank Manufacturer: ! ci� R KS X f P X £ <br /> Product Stored : � i S <br /> Diameter: 4190 <br /> (, Length : <br /> inches to the bottom <br /> of Tank : So 74 <br /> Volume of Overfill <br /> °ie 916M77 <br /> - <br /> c <br /> i <br /> � I <br /> PASS PASS <br /> jTest Result: PacesPRntfu Pass/ Fail I Pass/ Fail Pass/ Fail Pass/ Fail <br /> 74 <br /> Comments — (include information on repairs made prior to testing, and irecotnmendedTollotti•-up for failed tests) <br />