Laserfiche WebLink
AFFORDA-TE$T 416 2nd Street Galt CA 95632 <br />(209) 744-0112 FAX (209) 744-0116 <br />CONTRACTOR/ENGINEER <br />SITE NAME <br />M Ai:cq-�-. <br />leH L5 t�Prcis.F�G !cy � . <br />!-CD,4vtaN GA `ASZol <br />LINE & LEAK DETECTOR <br />TEST REPORT <br />TEST DATE <br />7Z <br />^j7--acl <br />Repair/Construction LOCATION SKETCH <br />Compliance r , 2�, snow Nortn� <br />Insurance 911, <br />GCS 1 <br />Escrow �� \v <br />Make & Type of Pump or Dispenser <br />Wny MF <br />Cover Over Lines' <br />GeUL�,w�� <br />Approx Burial Depth <br />Weather v� v <br />��u1�''/ ��ia'l21•\ <br />'4 I Pressure Suction SHOW STREETS, BLDGS, TANKS, ISLANDS, PIPING (IF KNOWN), PUMPS OR DISPENSERS <br />LEAK DETECTOR FTA LEAK DETECTOR TEST INFORMATION calib ah <br />10 PSI <br />Opening I Element <br />LD Serial Time In Test Leak Holding Pass / <br />KEY TYPES No/Product Key Number Resiliency Seconds Rate MUMin PSI Metering PSI Fail <br />A LD 2000 <br />B LD 2000 E <br />C FXI V <br />D FXI DV <br />E STPMLD <br />F STPMLD - D <br />G STPMLD-E <br />H STPMLD - D/E Notes: <br />CONTRACTOR LINE TEST RESULTS <br />CERTIFICATION Tests were made on the line systems as noted in accordance with test procedures <br />technic a C A. N1111nno prescribed for as detailed on the test chart on Side 2 of this form with results as follows: <br />PETROTITECCA020211 CERT3048 ��s�l PASS / AIL / INCONCLUSIVE •��n <br />CCA0202112304R <br />OTTL LIC#04-1676 PASS / FAIL / INCONCLUSIVE <br />Trainee: -PASS / FAIL / INCONCLUSIVE <br />______ PASS / FAIL / INCONr..IItsIVF <br />