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416 2nd Street LEAK DETECTOR <br /> Afforda-Te$t Galt,California 95632 ,LEST PORT <br /> (2091744-0112 800 524-9087 FAX(2091744-0116 <br /> Owner/Contractor/En TEST DATE: 5- Lo® .OENVIRONMENTAL HEALTH AGENCY: <br /> SITE NAME: O u I <br /> Site AddLQj",F3Q* �(. A r^,E� Zane A. m0 present Not Present <br /> !a o ►,� C A <br /> Phone: TECH SIGNATU INSPECTOR NAME: <br /> O erator Name: OTTL # I C 3322-UT <br /> LEAK DETECTOR KED' <br /> A LD2000 C FE Petro STP-MLD G Red Jacket FXIV <br /> LD2000/E D FE Petro STP-MLD-E H Red Jacket FXIVD <br /> E FE Petro STP-MLD-D <br /> F FE Petro STP-MLD-DE J I Other <br /> FTA LEAK DETECTOR TEST INFORMATION Calibratedto <br /> 10 si <br /> Dispenser Product LD Key Serial# Resiliency Opening Test Leak Rate Functional Metering PSI <br /> Number Time Element <br /> from above in seconds ML er Minute Holdini PSI Pass/Fail <br /> C Uo 319� 3 13 P F <br /> P/F <br /> P/F <br /> I=I tAE P/F <br /> S Gu+ u Al P F <br /> P/F <br /> P/F <br /> P/F <br /> P/F <br /> P/F <br />