Laserfiche WebLink
AFFORDA-TE$ 416 2nd Street Galt C 956 <br />(209) 744-0112 (209) 744-0116 FAx <br />I DETECTOF <br />TEST REPORT <br />CONTRACTOR/ENGINEER <br />TEST DATE �j <br />SITE NAME( s x e r, <br />0� PHONE (-57-0 ) ., <br />ADDRESS` <br />Compliance <br />Repair/Construction <br />LOCATION SKETCH Show North <br />Insurance <br />Escrow <br />Make & Type of Pump or Dispenser <br />e4 1P QC " <br />Cover Over Lines <br />a, r <br />Approx Burial Depth <br />Weather <br />SHOW STREETS, BLDGS, TANKS, ISLANDS, PIPING (IF KNOWN), PUMPS OR DISPENSERS <br />Pressure Suction <br />Calibrated to 3 gph @ 10 psi <br />FTA LEAK DETECTOR TEST INFORMATION Calibrate <br />10 PSI <br />LEAK DETECTOR KEY <br />Disp # / LD Opening Leak Functional <br />Time Rate Element Metering <br />Product Key Serial Number Resiliency In Seconds MUMin Holding PSI PSI Pass / Fail <br />A <br />LD 2000 <br />P F <br />B <br />LD 2000 E <br />P / F <br />C <br />FXI V <br />P / F <br />D <br />FXI DV <br />P F <br />E <br />STPMLD <br />P / F <br />F <br />STPMLD - D <br />P / F <br />G <br />STPMLD - E <br />P / F <br />H <br />STPMLD - D/E <br />Notes: <br />CONTRACTOR <br />LINE TEST RESULTS <br />CERTIFICATION <br />Technician: Lyle D. Nimmo <br />Tests were made on the line systems as noted in accordance with test procedures <br />prescribed for as detailed on the test chart on Side 2 of this form with results as follows: <br />PE 993AO1 CERT# <br />09Q993A0163 <br />LINE IDENTIFICATION NET <br />-.� /,"PASS// FAIL / INCONCLUSIVE <br />VOLUME CHANGE PER HOUR <br />, <br />PASS / FAIL / INCONCLUSIVE <br />OTTL Lic# 97-1143 <br />Trainee: <br />PASS / FAIL / INCONCLUSIVE <br />PASS / FAIL / INCONCLUSIVE <br />EQUIPMENT: PETRO TIT E LINE TESTER <br />