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' <br /> P .-O . 1:3UX 3048 7 . <br /> Stbcktnn , Callfornla <br /> .. (209) 931-1€320 ..�. L <br /> MjrR of SIM-� 1 , <br /> ADDRESS <br /> C I T V-L�1J1--_____STAT ERZ IP`�,,, <br /> OWNER OF TAtlKS <br /> ADDRESS !_ <br /> `1.d�-�--� CITY L• <br /> (VIEPATOR AT LOCATIUIJ <br /> � CITU <br /> flAf1E OF COUNTY ra )� ,-- <br /> 11114K <br /> -11114K # <br /> LON PLOT PLAN. AGE OF TANI< <br /> DESCRIPTION OF TAC'Jl<: <br /> CAPACITY �0O C) DIAMETE'RL-2 MCTAL� FIBERGLASS , <br /> TYPE OF SYSTEM: SUCTION : SU3MERSIBLE__y <br /> VAPOR RECOVF;RV SYSTEM? -� OTHER <br /> � PRODUCT BEING TESIEU U • J � TYPE <br /> ASUR 'DE�GFtAVITY , <br /> API SPECIEIC GRAVITY A 60°F L , <br /> 'S.:PtZODUC <br /> STORAGE ST ;�_ . �- <br /> 1LL O DATE 1 �- /.;?-5 TIME <br /> TESTED - DATE ,;�- r <br /> ` �� sIART , I'INISH <br /> LENGTH OF TEST - � c <br /> MEASURED WATER IN TANK_ _ IIEIGIFfi or LIQUID LEVEL ,S J r� <br /> DEPTH OF GROUND WATER_ <br /> 6 ' . PSI AT TANK BOTTOM <br /> RESULTS OF TEST: / <br /> ,r <br /> CERTIFIED TIGHT? - VES ; .NO <br /> LEAK RATE PER }TOUR: s - IF NO EXPLAIN IN REMARK5. <br /> REMARKS BY OPLRAIOR <br /> NAME OF OPERATOR Of <br /> SIG14AIL13E OF OPERATOR <br /> DATES <br /> } Lei, <br />