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CJJ J SJJ TA K TESTING C ONTRM -110N CEJ . <br /> P-U. BOX 311407 <br /> 0 EICEMSED <br /> ST{1CKl6H, CA 95ZI3 IHSORED <br /> (709) 931- 107-0 <br /> FAX (209) 465-3006 <br /> *FEST REPOR"t'* * **LICENSE f92-1248 <br /> —� LEONARD F. CRISP <br /> OWNER OF SIT �� �- -- -- --- ----- ----- <br /> ADDRESS:AL�N-A- "!-l_— CITY:�-vl�.-------, �1 zIP:A�- - <br /> OWNEROF T A Pd h S:. ------- --------- -------------T ----•-- --- . <br /> AUURESS:�,_-..�------- ------- CITY._..------------- ---_— ZIP:__--------- <br /> OPERATOR AT LOCATION:--_—___ _--_— ------- -,-----�- -- <br /> ADDRESS:_.__—_-_—__ _-- CITY:---------, <br /> COUNTYL�CL��[ 1I�----.- TANK*':-Z—. AGE:----- GALLONS:_A, ___.. <br /> METALV-) FIBERGLASS( ) SINGLE WALLED( ) DOUBLE WALLED( ) <br /> DIESEL( ) UNLEADED ( ) PREMIUM UNL. Y) — <br /> SUCTION( ) SUBMERSIBLER) OVERSPILL CONTAINER**YES( ) NO(Q'-) <br /> SHEAR VALVE`*YES( ) NO( ) IN-LINT LEAK DETECTOR**YFS( ) NO(Y'-) <br /> VAPOR RECOVERY SYSTEM**YES( ) NO(Y-) IFYES, PHASE i( ) PHASE II( ) <br /> TANK FILL DATE: 4, TIMR. <br /> � <br /> T ANK TEST DATE: A START:- It <br /> I,FNG'TH OF Tr-,Sl'::— tf) <br /> TANK BOTTOM TO GRADE.....__ftt_" TEST LEVEL TO TANK BOTTOM..... W_" <br /> TANK TOP TO GRADE............" GROUND WATER ABQVE TANK.... <br /> DIAMETER.*............................ ' PSI................................. <br /> ,......,.:....... .-�„ <br /> TEST LEVEL ABOVE GROUND._: NET TEST PRESSURE...........;.b......... � tz <br /> WATER IN TANK.................... -" API SPECIFIC GRAVITY.................. <br /> DEPTH FOR TAKING SAMPLE... TEMPERATURE................................._. <br /> TEMPERATURE PROBE DEPTH...._" API SPECIFIC GRAVITYo 60' F...... <br /> COEFFICIENT OF EXP­_.._............ <br /> LEAK RATE PER/HR:+______/ Q !4� <br /> CERTIFIED TIGHT: PESO-) NO( ) <br /> PRODUCT LINE TEST: SUC'T'ION( ) PRESSUREI q) <br /> LEAK RATS AER/HR: +----_- /- <br /> CFRTIFIED TIGHT: YES( ) NO( ) <br /> DATE:_VfQA5r _ SIC;NATURE o[., 'rr..STF _ <br /> COMMENTS:-----------------a-----------------___�_-�,�__ -------- <br />