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MECHANICAL LINE LEAK DETECTOR <br /> STATION NUMBER <br /> `1a- *EST DATA CHART DATE: /y 9y <br /> I.Location: (/ It21)MI <br /> LtreeL No. and/or corner <br /> ciLY ✓ .tat T iephone N <br /> 2. Owner: <br /> Name Addr es•s Representative Position Telephone No. <br /> 3. Operator: <br /> Name Dealer , Myr. Other <br /> Address, if Different than Location Telephone No. <br /> / <br /> Mechanic(s) NAME <br /> 0K KIEV r� L <br /> 1. MAKE: IT �__ Is 2. MAKE: <br /> Qd- <br /> TYPE or MODEL: D G dD TYPE or MODEL: <br /> SERIAL NUMBER: I0990 — �a SERIAL NUMBER: <br /> Plo—s4. MAKE: <br /> 3, MAKE: <br /> TYPE or MODEL: D L TYPE or MODEL: <br /> SERIAL NUMBER: za�� a�y SERIAL NUMBER: <br /> Full Opening Functional Bleed Metering I Test Leak <br /> No. Operating Time Element Back Pressure I Rate PASS REMARKS <br /> Pressure Holding <br /> PSI Seconds PSI PSI I GAL/HR YES NO <br /> 3 � � 3 <br /> 1 . . <br /> S c�N <br /> 2. <br /> PiL6 $ /-5' /o '7 3 <br /> 3. <br /> 4. <br /> A KNOLOG " <br /> 40883 B County Center Drive,Suite F•Temecula,CA 92591 <br /> (909)3081212•Fax(909)3081237 <br />