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Name of Supplier,Owner or Dealer Address No.and Street(s) City State Date of Test 15. TANK TO TEST 15a. BRIEF DIAGRAM OF TF.NK FIELD 16. CAPACITY From ❑ Station Chart Identit Nominal Capacity y Tank Manufacturer's Chart 19 �g Y b Y Position L F}tib Gallons ❑ Company Engineering Data �,�"� �"� ❑ Brand and Grade ey most occur to Charts supplied with int � L-7--n-3 capacity chartavaiteble op Lj ❑ Other Gallons 17. FILL-UP FOR TEST Total Gallons Gallons ea.Reading Stick Bottom 0 before re Fit Fill-uP In. V In. Inventory to u" Gallons Tank Diameter 18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK ❑Water In tank ❑ Llne(s)being tested with LVLLT See manual sections applicable.Check below and record procedure In log(27). ❑High water table in tank excavation I Use maximum allowable test pressure for all tests. 19. TANK MEASUREMENTS FOR Transfer total to line 25a Four pound rule does not apply to doublewalled tanks. Complate section below: TSTT ASSEMBLY 21. VAPOR RECOVERY SYSTEM ElStageI ElStage II Bottom of tank to grade' ............................ 1 In. Add 30"for"T"probe a„sy........................... 30.1n. 24b. COEFFICIENT OF EXPANSION 1. Is four pound rule required? Yes ❑ No ❑ Total tubing to assemble—approximate............. In. RECIPROCAL METHOD o 20. EXTENSION HOSE SETTING ')Pe of Product”""""""""""""""""""J" 2. Height b 12"mark from bosom of tank In. / Tank lop to grade•.................................. In. Hydrometer Employed.................................. H Extend hose on suction tube 6"or more Temperature In Tank 3. Pressure M bottom of tank P.S.1. Alter Circulation........................................ �' IF belowtank top...................................... In. Temperature of Sample W�' IF 4. Pressure M lop of tank p S I 'll Fill pipe extends above Prada,use top of 1111. '�"��'�"� " 4 r 22. Thermal-Sensor reeding after circulation 7 �� Difference(-/-)......................................... •F digi't`s'I •F Observed A.P.I.Gravity Depth of burial In. y C4 �Z� ................................. ��een 23. Digits per IF In range of expected change t" Reclprocalo�Lt %0 Page If Tank die. In. digits COEFFICIENT OF EXPANSION (Complete after circulation) ti xC� •�•3ca 1��C1hj 24a. Corrected A.P.I.Gravity Total quantity In Reciprocal Volume change In Water table In. full tank(16 or 17) this tank per IF NOTES: Observed A.P.I.Gravity................................... Transfer to Line 26e. Hydrometer employed................................... H Observed Sample Temperature ......................... •F 24c. FOR TESTING WITH WATER see Table C e D Corrected A.P.I.Gravity Water Temperature after Circulation Q60•F,From Table A.................................... Table C................................................ IF Coefficient of Expansion Coefficient of Water The above calculations are to be used for dry soil conditions to for Involved Product Table D................................................ establish a Positive pressure advantage,or when using thefourpound From Table ............................................ rule to Compensate for the presence of subsurface water in the tank Transfer COE to Line 25b. Added Surfactant? El Yes ❑No Transfer COE to Line 25b. area. Refer to N.F.P.A. 30, Sections 242.4 and 2-7.2 and the tank 25. (a) x (b) _ (C) gallons • manufacturer regarding allowable system test pressures. Total quantity In Coefficient of expansion for Volume change In this tank hull tank(16 or 17) / Involved product per IF 26. (a)ct` •3�1 ; 6 W L4 * L�� _ LJIJ 1 I jl This Is Volume change per IF(25 or 24b) Digits per IF In test Volume change per digit test Range(23) Compute to 4 decimal places. factor(e)