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Champion Precision Testing, Inc. <br /> PO Box 13059 Sacramento, Ca 95813-3059 <br /> (916) 927-1557 Fax (916) 927-7345 <br /> Electronic Leak Detector Test Data Sheet <br /> Site Name 4; s-'era Date. /0--Y-d'l <br /> Address Ll C a- <br /> Test Information <br /> 1 2 3 4 5 <br /> Product IQ, 91 <br /> Manufacturer "C-OCAP-0-e <br /> Model <br /> Line Bleed Back(ml) �5o ZOO <br /> Check Valve Holding Pressure 30 2-41' <br /> �Psi) <br /> (ml/min)(gph) 3 3 <br /> PASS or FA.EL Aa; p4 sr <br /> Comments: <br /> This letter certifies that the annual leak detector tests were performed at the above referenced facility <br /> according to the equipment manufacturers procedures and limitations and the results as fisted are to my <br /> knowledge true and correct The mechanical leak detector test pass/fail is determined using a low flow <br /> threshold trig rate of 3 gph at 10 PSI. <br /> Inspected By: Contractor- Champion Precision Testing Inc <br /> Technician—.6--k rAr Veeder-Root# S bf <br /> Signature <br /> Revision 5101 <br />