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AFFORDA-TE$T 416 2nd Street Galt CA 95632 LINE & LEAK DETECTOR <br /> (209) 744-0112 FAX (209) 744-0116 TEST REPORT <br /> FCONTRACTOR/ENGINEER o q TEST DATE <br /> ( - IZ-off <br /> SITE NAME OQ.ADd l n NIE'aiQST PHONE ( ) <br /> ADDRESS /oB�B /� L/rn/7o / <br /> %toy CA szrZ <br /> Repair/Construction LOCATION SKETCH <br /> x <br /> show how North <br /> Insurance <br /> Escrow <br /> Make &Type of Pump or Dispenser <br /> Cover Over Lines <br /> 4 C'o..Ic.rt�E,-rlL <br /> Approx Burial Depth / <br /> e-e(- <br /> Weather <br /> 4tI✓N <br /> Pressure Suction ]SHOW STREETS, BLDGS,TANKS, ISLANDS, PIPING (IF KNOWN), PUMPS OR DISPENSERS <br /> LEAK DETECTOR FTA LEAK DETECTOR TEST INFORMATION Calibrate <br /> 10 PSI <br /> Opening I Element <br /> LD Serial Time In Test Leak Holding Pass/ <br /> KEY TYPES No/Product Key Number Resiliency Seconds Rate ML/Min PSI Metering PSI Fail <br /> A LD 2000 g C O Z 89 3 I Z <br /> 5 <br /> B LD 2000 E <br /> It <br /> C FXI V <br /> D FXI DV <br /> E STPMLD <br /> F STPMLD-D <br /> G STPMLD -E RS z 1897('3 <br /> 897 '3 zU <br /> i( PP.SS <br /> H STPMLD-D/E Notes: <br /> CONTRACTOR LINE TEST RESULTS <br /> CERTIFICATION Tests were made on the line systems as noted in accordance with test procedures <br /> Technician:Zane A. Nimmo prescribed for as detailed on the test chart on Side 2 of this form with results as follows: <br /> LINE IDENTIFICATION NET VOLUME CHANGE PER HOUR <br /> _ i <br /> PETROTITE CERT# <br /> CCA0202112304R J ASS FAIL / INCONCLUSIVE <br /> CCA02D <br /> OTTL Lic#04-1676 — PASS FAIL / INCONCLUSIVE <br /> Trainee: G Q OC. PASS)/ FAIL / INCONCLUSIVE <br /> ASS FAIL / INCONCLUSIVE - , o o / o <br /> EQUIPMENT.PETRO TITE LINE TESTER -- <br />