Laserfiche WebLink
Champion <br />Precision Tank Testing <br />v� License No. 73848 <br />USTest 2000/P <br />0 <br />P.O. Box 13059 <br />Sacramento CA 95813-3059 <br />CA 800-660-9443 <br />NV 800-949-9443 <br />1-916-927-1557 <br />Fax: (916) 927-7345 <br />PRECISION TANK TEST( EVALUATION REPORT <br />THE US `fest 2000 System declares a tank to be leaking when the measured leak rate exceeds the threshold of .05 gph and has a probability of false: <br />alarm of el % and a probability of detection of> 99%. Champion assumes no responsibility for product leakage. Our responsibility extends only to <br />the testing of tanks as to tight or not tight, as of the date and levels tested. <br />Date: <br />1. 2. 3. <br />DIAMETER <br />1. Pressure ❑ Suction A <br />—0; 3 Pass 9Fail <br />❑ <br />Site ID: <br />Pass ❑ Fail <br />❑ <br />3. Pressure ❑ Suction ❑ <br />Pass ❑ Fail <br />❑ <br />Operator: <br />Pass ❑ Fail <br />n <br />Site Address: <br />] <br />Q o 1 ao z r� <br />City: <br />1 L <br />State: <br />On lob Site Time: I (Yp C) <br />Zip: <br />Phone: <br />Off job Site Time: 1 f O p <br />TEST <br />TEST <br />TEST <br />TEST <br />LEVEL <br />RESULTS <br />ULLAGE <br />RESULTS <br />] . t % <br />3 _ f -' _PassFail <br />❑ <br />1. % <br />',->Kt ', 1 ( -Pass Fail ❑ <br />2 % <br />Pass ❑ Fail <br />❑ <br />2. % <br />Pass ❑ Fail ❑ <br />3- % <br />Pass ❑ Fail <br />❑ <br />-1 % <br />Pass ❑ Fail ❑ <br />4. % <br />Pass ❑ Fail <br />❑ <br />4. % <br />Pass ❑ Fail ❑ <br />LINE TEST RESULTS <br />1. 2. 3. <br />DIAMETER <br />1. Pressure ❑ Suction A <br />—0; 3 Pass 9Fail <br />❑ <br />2. Pressure ❑ Suction ❑ <br />Pass ❑ Fail <br />❑ <br />3. Pressure ❑ Suction ❑ <br />Pass ❑ Fail <br />❑ <br />4. Pressure ❑ Suction ❑ <br />Pass ❑ Fail <br />❑ <br />TANK INFORMATION <br />TANK # <br />1. 2. 3. <br />DIAMETER <br />CDS <br />VOLUME <br />Z <br />PRODUCT <br />TANK TYPE <br />PROD LEVEL <br />f 1� <br />DIFF/ VOL, <br />1 ! Lj"(,) 4 <br />WATER IN TANK 4 <br />WELL POINT _St <br />GRND WATER [3t <br />LINE LEAK DETECTOR <br />1. Irl A Pass ❑ Fail ❑ <br />2. Pass ❑ Fail ❑ <br />3. Pass ❑ Fail ❑ <br />4. Pass ❑ Fail ❑ <br />Amount of Product Wait Time Before Precision <br />4. To Be Delivered Tank Test <br />_ <br />75%-90% 20 - 36 hours <br />_ <br />50%-75% 14 - 20 hours <br />_ <br />25%-50% 8 - 14 hours <br />_ <br />5%-25% 6 - 8 hours <br />_ Amount of Last Delivery = %6 of Tank Capacity. - Time _ Date <br />_ Tank 1 -1 GQ0 <br />_ Tank 2 <br />_ Tank 3 <br />Tank 4 <br />Minimum Test Time From Differential Volume Chart -(Min.) Tank 1: _qo Tank 2: Tank 3: Tank 4: <br />COMMENTS: <br />Any additional tank testing information requested b3• your office is on file at Champion Precision Tank Testing. Fuel delivery slips are <br />on file %%ith Tank Owner. <br />TECHNICIAN: William Campbell CA - LIC. 98-1324 - SIGNATURE. DATE- 6 J 4 , <br />