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OTHER CONDITIONS VAPOR RECOVERY PLUGS ❑ RISERS ❑ OTHER VENT ❑ NO PREPARATION ❑ OPEN TO ATMOSPHERE ❑ P -V VALUE REMOVED ❑ OTHER ,21OREMOTE/SUBMERSIBLE (DEPTH ) ❑ SUCTION (HEIGHT ) CHECK VALVE STRAINER IMPACT VALVE CHECK VALVE STRAINER SUCTION CONNECTION ❑ REMOVED & OPEN ❑ REM ED ❑ CLOSED ❑ BURIED ❑ REMOVED ❑ PLUG-IN END UNION ACE IN PLACE ❑ CLOSED OUT ❑ EXTRACTABLE ❑ IN PLACE ❑'COUPLING [�[]�JNP CLOSED &COVER ACE OPEN ❑REMOVED ❑ REMOVED EMOAVE D& COVER ❑ OPEN WITH FOIL ❑ REMOi4CED&COVER OTHER ❑ IN PLACE ❑ OTHER OPEN NO FOIL ❑ OTHER EOV ❑ CAP REPLQACED ❑ IN PLACE ❑ OTHER ❑ OTHER TEST 1 DATA TIME LEVEL LOCATION FILL GAUGE OTHER (SPECIFY) DROP TUBE IN OUT NONE. START V7 ( TEMP. PROBE END / L/ (— BALANCE AVERAGE CC's PER DIVISION 1 CAV OATC /e nl n CALIBRATION LOCATION / METHOD SOLID ROD ❑ LIQUID 1 2 3 4 5 6 AVERAGE CC's ADDED (+) OR REMOVED (—)� DIVISIONS AVERAGE CC's PER DIVISION 1 CAV OATC /e nl n LR = f DIVISIONS CC CC IN OUT _ MINUTE X CALIBRATION, DIVISION a MINUTE (+) OR (_) EMPERATURE COMPENSATION (TC) CALCULATION GT 53 VZ+y SYSTEM CAPACITY, GALLONS 0• F®� (f) TEMPERATURE DIFFERENTIAL, -F A AME— TIME OF TEMP. DIFFERENTI`AyL`, MINUTES CECOEFFICIENT OF EXPANSION 11-F 1 W GRAVITY TEMPERATURE ®F - SOURCE 13T(59C ❑ A ❑ D ❑ CHART ❑ B ❑ E ❑ PUBLISHED DATA AT 60'F ❑ C ❑ OTHER ABSOLUTE LEAK RATE (ALR) CALCULATION»` ' ABSOLUTE LEAK RATE - 3 3 -- 3. 3 i . G LEAK.OMPENSATION i' 71F, X CC/MIN 0.015652° GAL/HOUR ❑ HEALTH IF ALR > f 0.05 GPH, A CHECK TEST WAS CONO FIRMS THE ABOVE RESULTS (CALCULATIO I`f 4" 1 u AL IG` cola i 13AA CHECK TEST WAS NOT CONDUCTED BECAUSE Ei�W " 7. I ' ° 60 MINUTES/HOUR _ 3785 CC/GALLON = 0.015852