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R <br /> LEAK DETECTOR TEST <br /> • Q <br /> a Date: 3_�j- �i'.S <br /> � a <br /> 1S No. : 13 DHA: <br /> ddress:. <br /> ontractor: (�r� Job No. <br /> --'*'-id by - e:' <br /> �. (Print) 'S gnature <br /> Full Line Simulated L ne o <br /> roduct Pumpblock Model Pressure (PSI) Leak Test Seals Corrections . Mac <br /> O - Outside � a o Leak Detector <br /> M - Middle n v, o v, o a Open Close & impact valve <br /> I - Inside o o v � a Max. 12 Min. 26 Pass Fail (Date) <br /> apreme / <br /> Lar <br /> I t <br /> ,leaded <br />:her <br /> I <br /> �, a xc •w#,tA�. ".,„fir- ,.yr�sq„., #L+."�; � ° `��, `��..; +'. . �. `m. � <br />