Laserfiche WebLink
0 <br />fforda-Te <br />416 2"d Street Phone: (209) 744-0112 <br />LINE & LEAK DETECTOR <br />t <br />Galt, Ca 95632 Fax: (209) 744-0116 <br />TEST REPORT <br />afforda@softeom.net <br />CONTRACTOR/ENGINEER BAGLEY <br />SITE NAME:SAN JOAQUIN HOSPITAL <br />TEST DATE 9/5/2017 <br />SITE ADDRESS 500 WEST HOSPITAL RD PHONE �) - <br />CITY FRENCH CAMP CA 95231 <br />❑ Repair/Construction <br />LOCATION SKETCH show North <br />® Compliance ❑ Owners Request <br />❑ Insurance ❑ Escrow <br />❑ Other <br />Make & Type of Pump or Dispenser <br />SEP 0 5 2017 <br />RED JACKET <br />i <br />ENVIRONI` It:N,Tr,� HEALTH <br />Cover Over Lines <br />CONCRETE <br />r A ,,'T' a ENT <br />Approx Burial Depth <br />24' <br />Weather <br />SUNNY <br />SHOW STREETS, BLDGS, TANKS, ISLANDS, PIPING (IF KNOWN), PUMPS OR DISPENSERS <br />® I Pressure I SUctlOn ❑ <br />Calibrate <br />LEAK DETECTOR <br />FTA LEAK DETECTOR TEST INFORMATION 10 PSI <br />Opening <br />Test Leak <br />I Element <br />KEY TYPES <br />No/ <br />LD <br />Serial <br />Resiliency <br />Time In <br />Rate <br />Holding <br />Metering <br />Pass/ <br />Product <br />Key <br />Number <br />Seconds <br />MUMin. <br />PSI <br />PSI <br />Fail <br />A LD 2000 <br />B I LD 2000 E <br />C FXI V <br />D FXI DV <br />E STPMLD <br />F STPMLD — D <br />G STPMLD — E <br />H STPMLD—D/E <br />Notes: <br />CONTRACTOR <br />LINE TEST RESULTS <br />CERTIFICATION <br />Technician: <br />Tests were made on the line systems as noted in accordance with test procedures <br />Felix Ramirez <br />prescribed for as detailed on the test chart on Side 2 ofthis form with results as follows: <br />LINE IDENTIFICATION NET VOLUME CHANGE PER HOUR <br />PETROTITE CERT. #: CCA: 0203032811C <br />RED DIE ®PASS ❑FAIL ❑INCONCLUSIVE .0000 <br />OTTL License #: 08-1740 <br />❑PASS ❑FAIL ❑INCONCLUSIVE <br />Trainee: <br />[]PASS ❑FAIL ❑INCONCLUSIVE <br />JOSH POWELL <br />❑PASS ❑FAIL ❑INCONCLUSIVE <br />EQUIPMENT: PETRO TITE LINE TESTER <br />[]PASS ❑FAIL ❑INCONCLUSIVE <br />