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04/19/05 TUE 10:04 FAX 9512705121 CIRCLE % STORES Z018 <br /> SWRCB,January 2002 �J. 100 1 Page I of� <br /> Circle K - #2701205 5. SECONDARY PIPE TESTING <br /> 16470 Cambridge Dr Piping Manufacturer ®Industry Standard Professional Engineer <br /> Lathrop, CA 95330 Other(Specify) <br /> N04312 —SB 989 testing APressure Vacuum Hydrostatic <br /> Other(Specify) <br /> Test Equipment Used: see attached testing procedures Equipment Resolution: <br /> Piping Run# Piping Run# Piping Run# Piping Run# <br /> Piping Material: l 1 <br /> Piping Manufacturer: \ <br /> Piping Diameter: l <br /> Length of Piping Run: <br /> Product Stored: <br /> Method and location of o 67 t� \ <br /> i io •run isolation: <br /> Wait time between applying <br /> pressure/vacuum/water and <br /> starting test: 1` <br /> Test Start Time: `Q <br /> Initial Reading(Rt): <br /> Test End Time: <br /> Final Reading(RF): <br /> Test Duration: 1 hour 1 hour 1 hour 1 hour <br /> Change in Reading(RF-RO: <br /> Pass/Fail Threshold or 0 0 0 0 <br /> _ <br /> Criteria: <br /> _ n <br /> _. <br /> Comments—(include information on repairs made prior to testing,and recommended follow-up for failed tests) <br />