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i1O W s <br /> TANK TESTING <br /> i?+O Tet Rei <br /> W. ALDER v7 rr] <br /> STOCKTON, CA 95204 Underground Storage Tan <br /> HORNER SYSTEM <br /> OWNER OF SITE .E'�Dri /� ASS <br /> ADDRESS OF OWNER_Z/ ?g /I �i y CITY <br /> _Z STATE ZIP <br /> 0WNER OF TANK _T 2 i �/ 4 <br /> ADDRESS OF OWNER CITY,t/ CITY �!- STATE Z I P � <br /> NAME OF OPERATOR AT LOCATION /; <br /> ADDRESS OF LOCATION CITY STATE_ ', ZI P �S� O <br /> NAME OF COUNTYck2 v ,✓ <br /> TANK ## -F ON PLOT PLAN LOCATION. STORAGE SYSTEM FiLLED: DATE �7..2-?-f6TIME l,9�90 <br /> DATE OF TEST/L)-30f,6 TIME OF DAY: START FINISH /-2/ 7 <br /> LENGTR OF TEST .;,� 3.?�►neJ. Arlin TEMPERATUREd <br /> DISCRIPTION OF TANK-CAPACITY Qp DIAMETER '' METAL X FIBERGLASS <br /> TYPE OF SYSTEM- SUCTION SUBMERSIBLE__,K__OTHER <br /> TYPE OF VAPOR RECOVERY SYSTEM <br /> TYPE OF PRODUCT BEING TESTED ,Es�� MEASRURED GRAVITY 3�2 © COEFFICIENTsrs- <br /> TEMPERATURE OF PRODUCT_ jam/ o <br /> MEASURED WATER IN TANK --0— DEPTH OF TANK TOP FROM GROUND LEVEL <br /> DEPTH OF GROUND WATER��, �,��L,, / HEIGHT OF LIQUID LEVEL IN TEST STAND OR STAND PIPE <br /> AGE OF TANK AND LINES <br /> RESULTS OF TEST: CERTIFIED TPIGHT: 'YES NO IF NO EXPLAIN IN REMARKS BELOW <br /> LEAK RATE PER HOUR: + <br /> REMARKS 6Y OPERATOR ,ea uc ficoy .sir/ <br /> / di .✓ 5a nl / Z--'/5 ✓ Cr'c-) <br /> zC;yll Ll 7�t 7-` i e-, <br /> ,JAN 0 NAME OF OPERATOR <br /> ENVIRUMENTAL HEALTH SIGNATURE OF OPERATO / <br /> FERMIT/SERVICES <br /> DATE //- - <br />