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CRISP' TANK TESTING Test Report'' <br /> ;40w. ALDER <br /> S TOCKTONderground Storage Tar <br /> HORNER SYSTEM <br /> OWNER OF S f TE �3D T� �� a�rrQ�-s - - <br /> ADDRESS OF OWNER //399 ,t� ii C IT Y <br /> ^STATE z I P�S.Z5�0 <br /> OWNER OF TANK <br /> ADDRESS OF OWNER //.3 �b �/ rf �''9 _C I TY STATE ZIP � O <br /> NAME OF OPERATOR AT LOCATION % 7— ZIP <br /> CITY STATE a <br /> ADDRESS OF LOCATION //��'?l � ,��yp9 _ ��. <br /> NAME OF COUNTYo <br /> TANK r# ,f ON PLOT PLAN LOCATION. STORAGE SYSTEM FILLED: HATE / Z ,- TIME /moo <br /> DATE OF TEST_,,a Q - 6 TIME OF JAY: START 0 FINISHZZ per_ — <br /> LENGTR OF TEST ,:2 AiR TEMPERATURE � <br /> DISCRIPTION OF TANK-CAPACITY SSD DIAMETER 95/'" METAL X FIBERGLASS �• <br /> TYPE OF SYSTEM- SUCTION SUBMERSIBLE ,X OTHER <br /> TYPE OF VAPOR RECOVERY SYSTEM ,J E - <br /> TYPE OF PRODUCT BEING TESTED )A57-JE MEASRURED GRAVITY COEFFICIENT,crO»S <br /> TEMPERATURE OF PRODUCT <br /> s� <br /> MEASURED WATER IN TANK --0— DEPTH OF TANK TOP FROM GROUND LEVEL_ <br /> DEPTH OF GROUND WATER HEIGHT OF LIQUID LEVEL IN TEST STAND OR STAND PIPE <br /> AGE OF TANK AND LINES <br /> RESULTS OF TEST: CERTIFIED TIGHT: YES NO IF NO EXPLAIN IN REMARKS BELOW <br /> LEAK RATE PER HOUR: 0 <br /> REMARKS BY OPERATOR <br /> ♦i <br /> l�Ull <br /> `1 <br /> NAME OF OPERATOR <br /> ENVIROIoIENTAL HEALTH /�_ ✓ -z% <br /> 'FERMIT/SERVICESl z <br /> S I GIIATURE OF OPERATO <br /> DATE /- <br />