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DATA CHART <br /> For Use With <br /> ( <br /> pvwtf u: <br /> 1 LOCATION: '�J� _ -o��-o c TI, <br /> u LIMN <br /> —��{� n0/ Corn (` Cl" Suw TMW�eM Na <br /> O 2 OWNER: , "'-'-� <br /> N•n'� ApOnw _ R•wn•nuu.• ►wiuen Twer.en.Nw <br /> ]OPERATOR:_ ��I <br /> N D-W,4pr,a Der Aoor•w(II 411N•r•nl p n Lo tbn) T•4Wgn•M0. <br /> l REASON FOR TEST_-�`^��1 i.�I�1�—�F-�• r <br /> 2 <br /> r o f TEST REQUESTED 6Y: 7L � <br /> � '"o N•T• r+.xn ora•.Np, tlpirq Aoor••• <br /> tai •SPECIAL INSTRUCTIONS: <br /> (- 7 CONTRACTOR OR COMPANY MAKING TEST <br /> MECHANIC(S) NAME ('-i} <br /> LLO� t IS A TANK TEST TO BE YES t MAKE AND TYPE OF <br /> MADE WITH THIS LINE TEST? PUMP OR DISPENSERS <br /> ❑NO <br /> COVER APPROXIMATE <br /> �• <br /> 1 �1 CA,-�_�_ <br /> I WEATHER A _TEMPERATURE IN TANKS_'F_'C OVER LINES_ �I \ — BURIAL DEPTH <br /> COrrCr•1•,pl•N 7p0.•IG <br /> 14 PRESSURE 1f VOLUME It TEST RESULTS <br /> 11 IDENTIFY 1] LOG OF TEST PROCEDURES.12 TIME <br /> EACH LINE AMBIENT TEMPERATURE D•I OR kP. READING <br /> AS TESTED (MILITARY) WEATN ER.ETC NET CONCLUSIONS.REPAIRS AND COMMENTS <br /> BEFORE AFTER I BEFORE AFTER CHANGE <br /> ) o <br /> 11 5 �5 <br /> Cha, <br /> 44- <br /> rmc <br /> 0 +ID3 <br /> – , 1 <br /> Ij <br /> 002 <br /> 1C'`J '�,42 r3-r <br /> �1.0 <br /> C��c 0 <br /> L.1 <br /> r — <br /> Clp``__ <br />