Laserfiche WebLink
POB 36 26515 N. Sacramento Blvd. � <br /> Afforda-Te$t a• Static Torque&Rotation <br /> Thornton, California 95686 <br /> (209) 794-0102 (800)524-9087 FAX(209)794-0112 Drop Tube Pressure Integrity <br /> Contractor/EngineerOrdering Test(ifany): <br /> TEST DATE: / �— TIME:; <br /> SITE NAME: � I,v �(' <br /> --� �✓1� 1 A�- 30'J start a <br /> UP Annual rECHNICIANNANM: &b J90WMan <br /> O erator Name: <br /> Owner- <br /> Site � <br /> Site Address: 0+//� l TECH SIGNA) �U'.� Address: <br /> r �. <br /> Phone: AIR QUALITY AGENCY:J <br /> INSPECTORNAMH: tJ� d <br /> FACILITY INFORMATION <br /> C,Application, Gasoline Disp Present Not Present <br /> or Per»tit# Facility# Phase I Type D QV <br /> STATIC TORQUE&ROTATION Phase II Type <br /> Ib " <br /> yaporAdVtor, 1 Ib PRESSURE INTEGRITY <br /> � rt DROP ^ <br /> Brand: �� 9gep 4r.Ms�txse el�I kelMQc�e akefhIadel, <br /> Gxa�le ]lowrate che �of Make/Moclel: <br /> Model: o s�, r $t , �SpillB#tcket Rotatable Rotatable <br /> �. i'soductAda to <br /> �Contaiprttent a ,VprAdaptor <br /> .� 1, P <br /> Prod.Grade: <br /> Torque#1: <br /> 76 _► 2 (,v`1 ' . <br /> Torque#2: <br /> -7o r yh G 0 /. Li <br /> Tor ue#3: 7 <br /> Avera 7c <br /> i <br /> 360.°Rotation: ;des / No Yes / No Yes / No Yes / No <br /> ProductAdaptor: 1nj <br /> ? fir v3A Y q..s.I FS,_ <br /> Brand: <br /> Model: <br /> Comments <br /> ProductGrade: <br /> Torque#1: 70 <br /> Torque#2: 70 <br /> Torque#3: 70 <br /> Average: <br /> 360totation: des f No Yes / No Yes / No Yes / No <br /> J.Pow Meter Calihrnf;on ,; Pressure Device Calibration <br />