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Vmi <br /> Vaporless Manufacturing, Inc. "" t - <br /> Quality Petroleum Equipment <br /> Solutions for Over 20 Years �'- 1 9 2017 <br /> LDT- 890 Test Form & VMI Warranty Checklist <br /> Oemher 1",1006 ENVIRONMENTAL HEALTH <br /> Test Information DEPARTMENT <br /> _ <br /> Date: 1 a I a- ;tct�l Test Company: <br /> Telephone: Contact: <br /> Sitel.D:aazv+ rtoD oyrP R- &Address: <br /> City: 6 AL-t- State: Zip: <br /> Type of Test Equipment: eFL 9 D <br /> Submersible Pump Identification <br /> MFG: I 1�E { ."c` Model No: Serial No: <br /> Leak Detector Identification <br /> Crrt" <br /> MFG: Q Or Q Model No: L t2Ln0x Serial No: <br /> Replacement Leak Detector Identification // q <br /> MFG: �� l Model CNa Serial No: I ID I DCf I <br /> Line Conditions <br /> 1. Type of Pipe: 2. Diameter of Pipe: 3. Length of Pipe: <br /> 4. Burial Depth of Leak Detector: 5. Kind of Fuel: J `1 6. Date of Last Line Test: <br /> Test Conditions <br /> 1. Operating Pump Pressure: iZ 2. Gallon per hour test rate:-,0 @ 10 psi <br /> 3, Static Line Pressure (Pump Off): e22— 4. Bleedback Test (Pump Off): ml. <br /> 5. Step-through time to full flow 3 seconds (0 psi, to full pump pressure, no leak) <br /> 6. Leak detector stays in Leak Search Position with a 3 GPH leak -Yes: PASS No: FAIL <br /> 7. Was the leak detector adjusted -Yes: No: � <br /> (See Website -www.vaporless.com -Technical Bulletin 032805) <br /> Symptoms <br /> 1. Won't find 3 GPH leak: 2. Stays in Slow Flow: <br /> 3. Other: <br /> ************ If This Unit Is Returned Under Warranty Please Complete The Following <br /> Vaporless RGA#: Return By (Company): <br /> Telephone: Contact: <br /> Customer Control #: Address: <br /> City: State: Zip: <br /> r <br /> Vaporless Manufacturing,Inc. <br /> 8700 East Lang Mesa Drive,Prescott Valley,Arizona 86314 <br /> 800-367-0185 928-775-5191 Fax: 928-775-5309 <br /> Email: vmi@vaporiess.com Web Site: www.vaporless.com <br />