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4 d <br />11 IDENTIFY <br />EACH LINE <br />AS TESTED <br />to <br />Z <br />DATA CHART <br />Work Order# fj2225 <br />For Use With <br />Station # 213 3 <br />6 TEST REQUESTED BY: <br />I LOCATION:- 2208 njamin <br />_Hgjj _MLtOCkton <br />t <br />Ca.(209)478-55552 <br />Rome <br />Oldw N& <br />saw <br />2 OWNER: <br />6 SPECIAL INSTRUCTIONS: <br />Nsa»AddMW <br />Pedfte <br />TdwI14" Na <br />3 OPERATOR: <br />ME- wilkers-0-n <br />N Sacramento Equipment <br />MECHANICS) NAME <br />PIN" <br />DNIK Met. of Dow <br />Ad*M (If iffiffomt w. E—.�) <br />4 Na <br />4 REASON FOR TEST <br />4 d <br />11 IDENTIFY <br />EACH LINE <br />AS TESTED <br />to <br />Z <br />0 <br />6 TEST REQUESTED BY: <br />Rome <br />Oldw N& <br />6 SPECIAL INSTRUCTIONS: <br />7 CONTRACTOR OR COMPANY MAKING TEST <br />ME- wilkers-0-n <br />N Sacramento Equipment <br />MECHANICS) NAME <br />Maintenance <br />Com pa!ly, Inc. Lee Roeves <br />1-3 <br />6 IS A TANK TEST TO BE YES 9 MAKE AND TYPS OF <br />MADE WITH THIS LINE TEST? NO PUMP OR DISPENSERS <br />10 WEATHER TEMPERATURE IN TANKS ® *F — 'C <br />COVER <br />OVER LINES <br />APPROXIMATE - <br />BURIAL DEPTH <br />12 TIME 12 LOG OF TEST PROCEDURES, 14 PRESSURE <br />UME <br />is TEST RESULTS <br />(MILITARY) AMBIENT TEMPERATURE, psi OR kpm READIN y NET <br />WEATHIP. ETC. <br />BEFORE TAFTER I BEFORE <br />I AFTER CHANGE <br />CONCLUSIONS, REPAIRS AND COMMENTS <br />Line Test Quick Reference <br />Results: I Date <br />Unlead <br />Premiu <br />Diesel <br />