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c� I OWNER OF SITE <br /> CRISP TANK TESTING - 7 �` <br /> N'rtlLs <br /> Ste04 Piccoli R95205 HORNER EASY TESTING METHOD 3 140 ADDRESS <br /> Stockton, CA <br /> . 36 3 -7 N 3176 Al. pw V q1 <br /> WORKjORK SHEET CITY-STATE-ZIP co6E <br /> R G - 524© <br /> OWNER OF TANKS <br /> TANK No. <br /> TEST LEVEL i a h PRODUCT,;0 L CAPACITY �5 CHART CAL (A) <br /> 7 7'" O � � �3 J�tB) <br /> ADDRESS <br /> MEASURED GRAVITY I/ IQ _ PRODUCT TEMP 0 COEFFICIENT TEMP CAL � ���� � 1 <br /> Air Temp 7.20 I396 w <br /> EST LEVEL LEVEL GAIN+ x(A) LEVEL TEMP. TEMP. GAIN+ x(B) TEMP. FINAL CITY-STATE-ZIP CODE <br /> START END LOSS- x(A) RESULT START ENO LOSS- x(B) RESULT RESULT TIME <br /> - <br /> _ x ' 0 A _ d T• a SQ X 0$�� OPERATORS NAME AT SITE <br /> l.I f••) /�lv fJ� <br /> x - x t eJ O / 7 F D J 7 TYPE OF SYSTEM <br /> r� r . a9 . 1/� 1130 <br /> J 1430 SUBMERGE Q SUCTION <br /> /�I/ �] - Q f c� S� x ��� ` '01/0 <br /> . 0-31/0 <br /> -31/p /a 7� LENGTH PIPEOF COLOR CODE OF PRODU' <br /> FILLiJ �+B�. x , 4 tj L� ✓ CLEAR ORANG <br /> `f �-y �� RED <br /> x , a 0 ry� x. (�I '1 i. © 3/8 DIAMETER OF TANK METAL <br /> /700 0 <br /> i 7c + <br /> � x , © � � / Q� j ` ¢, d��x " . p 148 0/a8 �� TYPE OFRECOVERY SYSTEM <br /> S ( f� I <br /> `f ¢ /7/s- ©BALANCE [] REQ JACKET 0 KEAL <br /> x sc / s x T 0/3.1yl 10 h <br /> f �J • +� +� • r 00 / O WATER LEVEL IN TANK Liquid /level <br /> 3 o <br /> x o39 x- l9 ` , oo-77 F . Qo77 , � <br /> ♦ .► �' DEPTH OF GROUNDWATER (IF KHOYYN) <br /> 7' /7�� <br /> xY l 3 p ,f �4 1 s 0 �° x / 98 � , 407 ,00 '79 ��Do 8 610ev o ' <br /> DATE ITIME STORAGE SYSTEM FILLED <br /> DATE TIME <br /> STATION LOCATION I 'r - CERTIFIED TIGHT <br /> 5 1D-/3�7 <br /> AGE OF TANKS <br /> ADDRESS w` LEAK RATE PER HOUR <br /> Ci T 11 0 2J 1 514A f E - - OPERATOR o �1 � r a �• e. 'r f J AGE OF LINES <br /> DATE /© r SIGNATURE <br /> _ V TESTING FLUID.IF DIFFERENT THAN <br /> STORED MATERIAL <br />