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J <br />Champion Precision Testing, Inc. <br />P. D. Box 6398, Bakersfield, CA 93386 <br />(661) 363-7400 Fax (661) 363-7474 <br />Lic # 848150 <br />Electronic Leak Detector Test Data Sheet <br />Site Name /< Lk) i X V ,,-c <br />Date 1 0 t '3� j 6-? <br />Address CI o Lj s I, k 7" . 7`r�° y w C -f r .i 3--7). <br />Test Information <br />Conu-nents: ____: 14-5P <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 listed are to my <br />knowledge true and correct. The mechanical leak detector test pass/fail is determined using a low flow <br />threshold trip rate of 3 gph at 10 PSI. <br />Inspected By: Contractor_ Champion Precision Testing, tnc <br />Technician L l t 1j ettvJ Veeder-R.00t # <br />Service Technician # <br />Signature <br />R�;1[si«n 5181 <br />l <br />2 <br />3 <br />4 <br />5 <br />Product <br />S <br />Manufacturer <br />iZ <br />U <br />v 9� <br />Model <br />Line Bleed Back (ml) <br />Check Valve Holding Pressure <br />(psi) <br />i <br />Z <br />Test Leak Rate (ml/min) (gph) <br />5 <br />-3r /A <br />PASS or FAIL <br />t>�'5.5 <br />1�-45 S <br />5- <br />/0 <br />Conu-nents: ____: 14-5P <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 listed are to my <br />knowledge true and correct. The mechanical leak detector test pass/fail is determined using a low flow <br />threshold trip rate of 3 gph at 10 PSI. <br />Inspected By: Contractor_ Champion Precision Testing, tnc <br />Technician L l t 1j ettvJ Veeder-R.00t # <br />Service Technician # <br />Signature <br />R�;1[si«n 5181 <br />