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LDT-890 Leak Detector Test Recof <br /> Contractor Customer <br /> zll`e o��a�Alec �orl jh� �JerS /(�o +e� 6-2-A <br /> Date Location Product ,,�� <br /> 2- 1r.1ao �a✓1s. OW 4`,l G IJ 33 /'I elr,/-A <br /> Technician //,,.. <br /> J.e4,lr -:Io <br /> Submersible Pump Identification <br /> Manufacturer Model No. Serial Number <br /> Leak Detector Identification <br /> Manufacturer Description Other Style Leak Detector <br /> 4 1-skQ Diaphragm-type <br /> X�y <br /> Piston-type 17— _J"// 3 <br /> Tamper-proof seal installed? Yes No <br /> Leak Detector in Submersible Pump <br /> Test at Dispenser <br /> 1. Operating Pump Pressure ;�'7 psi (para. 15) <br /> 2. Gallons per hour rate 3, o (para.22) <br /> 3. Line pressure with pump shut off __9psi (para.23) <br /> 4. Bleedback Test with pump off__2/ ml (para.26) <br /> 5. Step-through time to full flow-11-55-- seconds(para.30) <br /> . 6. Leak detector stays in leak search position.(para.42) Yes <br /> No <br /> LEAK DETECTOR TEST <br /> Note: Pass=Leak detector fits test protocol <br /> Fail=Leak detector fails test protocol <br /> Pass <br /> Fail <br /> Form 8900(9-1-96) *Complete thermal expansion test before failing leak detector. <br /> 1996 Vaporless Manufacturing,Inc.,Prescott Valley,AZ <br />