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Ask <br /> POB 36 26515 N. SACTO. BL. LI E & LEAK DETECTOR <br /> Affl�xrba aefif THORNTON, CA. 95686 TEST REPORT <br /> CC 209 794-0102 800 524-9087 <br /> CONTRACTOR/ENGINEER TEST DATE 31(-1z <br /> ORDERING TEST <br /> SITE: <br /> OPERATOR SIAIiunH OWNER <br /> SITE ADDRESSADDRESS <br /> PHONE - PHONE <br /> REASON FOR TEST-- LOCATION SKETCH ✓ <br /> LINE(s)ONLY TANK(s}LINE(s <br /> LINE(a)-LEAK DET. <br /> TANK(a)-LUIF,IB}LEAK DET. <br /> / 7 <br /> RURB t TYPE OF <br /> ORvdPaNSER o -C ,ov ' <br /> COY"OvRR / i <br /> LU$a 1, m Lie re FF SN () . <br /> APPROX BURIAL <br /> U'F17f1 02 ]1"' <br /> KLWeAl1MA /-LN r SUCTION 311"SIRTANKS ISL ANDS PIPfNOIP KNOWN1 PUMPS OR DISPENSE" <br /> LEABDETECTOR FTA LEAK DETECTOR TEST INFORMATION c'ebr#Ae <br /> l0 PS <br /> Serial pm Teat an on d g Ya/ <br /> y T1PES. N wd '�D Number ResUlmcy 77me Leak Raft Element PSI No <br /> ["Ls <br /> oldie PSl <br /> XLD P/N 116036-3 / eIf k tl0 93 4 r 2 t > t <br /> PLD PIN 116030fi � ��L 062, <br /> XLP P/N 116033-5 <br /> DLDP/N116017-5 2J71100 A VOU4'3 9/'93 / <br /> BP'LD P/N 116012-3 <br /> o»1R <br /> Nota <br /> CONTRACTOR LINE TEST RESULTS <br /> CERTIFICATION IMS WEREAUOE ON 7HELINESY87WSASN07F.D UJACCORLWNCE NMI nHST <br /> TECtINIC L IMMO PRUCFUURESPRESCR/REDrVR ASDEPAILF00,V7HETE'SICHARTONsm6S <br /> nwnnu <br /> oFRnSFVPN1P7n! UL7SASrl71W"— <br /> LINEIDEN7'1FICATION NET VOL UNE C GBPER HOU <br /> PLTRO CERT. 1090993A0163 141- i�i< PAS / FAIL / INCONCLUSIVE OC /c <br /> OTTL LIC a f7-IIO <br /> rai.er, NE ,-/vV`"lG +� !�K PASS / FAIL / INCONCLUSIVE f QDOO <br /> 'hbwalO�' �" PASS / FAIL / INCONCLUSIVE DSU <br /> IBA NO PETRO-WE <br /> �_.___ <br /> L2c 12M PASS / FAIL / INCONCLUSIVE <br />