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DATA CHART FOR TANK .SYSTEM TIGHTNESS TEST <br />(EZY CHEK) <br />CLIENT <br />NAME OF SUPPLIER, <br />c <br />OWNER OR DEALER S S r a CO / W <br />VA r -r4 DATE OF TESTL,2 9'9'0 TIME START TIME FINISH <br />LENGTH OF TEST <br />ADDRESS (NO. & STREET) <br />WEATHER L2 v <br />TEMPERATURE S4 <br />CITY AND STATEn <br />- <br />TANK INFORMATION <br />CAPACITY (NOMINAL) I o 0 0 GALS. <br />SIZE OF FILL OR TEST OPENING cf IN. <br />CONTENTS 0,01Iesc4s H/, <br />CAPACITY (CHART) GALS. <br />DIMENSIONS: DIAMETER <br />TOP OFF TIME HOUR DATE _ GALLONS <br />(PRODUCT) . <br />TANK MATERIAL METALhLj �IBERGLAS3( ) <br />LENGTH <br />NUMBER OF GALLONS ADDED TO START TEST _ <br />APPROX. AGE <br />TANK NO. <br />PUMP SYSTEM. -TYPE -SUB( ) MAKE <br />INCHES OF WATER - BEFORE TEST - s.FTER TEST $ <br />SUCTION QCi <br />TEST CALIBRATION _ <br />' <br />- LEAK `OETECOR YES F7NO <br />SIZE OF CAL. BAR OR ML'S ADDED <br />TANK LAYOUT <br />• O �� - _ ��, 3 =�0 � <br />.) <br />-VAPOR RECOVERY SYSTEM YESG )- NO( <br />LINE MOVE T <br />(ALM) IFiCMRA). <br />_IT_ <br />_ LINES <br />- <br />2 to 3 �i <br />LINES <br />3 to �_C <br />/ Z LINES <br />__. TOTAL <br />_ <br />J / <br />'(;6 LINES : 3 = -�--- LINES <br />- <br />- (ALM) <br />END OF TEST CALIBRATION <br />SIZE OF CAL BAR OR ML'S ADDED <br />_. <br />UNE MOVEMENT _ <br />(ALM) (FAC -MR A) <br />... <br />I - S to �� _ <br />/ 0 LINES <br />2 to _ <br />3 to r) _ <br />/ d LINES <br />/ '? LINES <br />TOTAL <br />j2 LINES = 3 LINES <br />MEASURED API $PfCIFIC GRAVITY <br />PRODUCT TEMPERATURE <br />API SPECIFIC GRAVITY * 60° F 5 rs <br />(FROM TABLE A) <br />- <br />COEFFICIENT OF EXPANSION-.LLQ__C? 6 D X? <br />(FROM TABLE 8) <br />� <br />(FkCTOR B) <br />- <br />_ e <br />e.o..._ <br />TOTAL CAPACITY IGALI CHANG F , <br />� <br />. .. as .-. „+. <br />�� ... • <br />- <br />PRODUCT UNE -TESTING . w .- . w -a <br />'"� <br />- `:` SYSTEty� <br />Tw.;.PRODUCT NITDRUdGONCI plow- <br />Serial umber <br />OWNEf SITE <br />.. <br />ADDRESS <br />+ e.. <br />Start &Id <br />CITY" - .. <br />STATE ZIP CODE <br />OWNER OF TANK <br />„ <br />ADDRESS <br />M <br />" ;,: `mss �" t3 <br />.� <br />CITY <br />-- STATE ZIP CODE t- <br />�> <br />' •r .. ..a <br />�.._ <br />s <br />�' �COUNTY <br />� <br />�_ <br />w<•" mow-' .. <br />: <br />.. <br />TECHNICIANS <br />DATE <br />