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Piping Material; <br />y -r -"b �•"" •, <br />F; tic v / $ S �`�� /mss <br />� r 4E1ll1�' nun ri <br />Piping Manufacturer: <br />v� s <br />yl <br />y <br />Piping Diameter: <br />Length <br />2 Z' D 1) A 2 1 2-11 d, (� <br />of Piping Run; <br />Product Stored; <br />Method and location of <br />t <br />i in=nin.isolat on: :.. <br />tcsi N pL°`f3 y' cNt�J i.enL 33 y <br />Wait time between applying <br />d <br />pressor cuumtwater an4 <br />test: <br />S (v m rr(0"l-, <br />Test Start Time: <br />Initial Reading (R): <br />Test End Time: <br />t <br />Final Reading (RF): <br />Test Duration: <br />t <br />` <br />Change in Reading (RF -RI): <br />Pass/Fail Threshold or <br />Criteria: No L055,,.-, 1 5--r7 N 6 <br />. ,......, ..._... ,. <br />�9. . ai 1. <br />,. ,,... : � ,.._..... C? 1(f�SSr..., f�'•�''IIll' <br />Comments — include in ormation on repairs made Erior to testing, and recommended ollow-u <br />or ailed tests <br />kiu l e u! I <br />d; <br />vass d✓e- i�,i 5"ee0;4 i �r t ta4 1 e)J <br />� <br />� Ll S 414 o/ -- <br />�.J el (if <br />�! !J i� t 4 ct� Mkt iy�o�S u.v <br />j 5 % T CCf -a ale r.n <br />pp <br />� <br />S�� <br />