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Elite IV Contractor Inc. . <br /> 2535 Wigwam Dr. <br /> Stockton, CA 95205 <br /> (209)-4(51-6337 <br /> fax(209)-461,43342 <br /> Monitor / Leak Detector Verification <br /> Monitor: Make / Model —14 S^ZS U f Serial # <br />;.;• Sensor: _ <br /> Manufacturer t vole # <br /> 1 y3 90 Serial # ; oration <br /> 11 R �; <br /> 2)_.y't fiYL.��,!' �_ U��Iwu d' r4 IrV� S,t%.�./...—._.�._1.4;M�'L . r..ttY1N�P✓ : . <br /> i <br /> 3) - u- <br /> /( r.� I /1�G' LN oaG[ 1 � W� C.r. ti/ 1,4._ <br /> �._.._ 6L .A�.. <br /> Leak Detectors: <br /> --' -'lSerial # ;Tank# <br /> Manufacturers- ;Model t# n q <br /> ��1 ,%_� rill. . .... . <br /> 4) <br /> Does site have positive shutdown? Yes! No <br /> ayes �._ <br /> Do all sensors activate alarm and shut-down relay ? e. / No <br /> If no, disribe: <br /> Do leak detectors close with loss of line pressure 7 Yes I no — <br /> Do leak detectors remain closed with simulated leak? e /no <br /> Notes. " .S �- ti ,S V✓' ) t .n 4�h H H a / N/' Cj <br /> Y <br /> ny t' uilh.� / r5 ��f� A/'auHaf [ <br /> C / I r <br /> ,SCtCf� �rC � al a�� l CtAHviul °)i 7f� ft <� �7 <br />