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Comments — (include information on repairs made to testing) <br />Technician: Lyle D.* Nimmo ICC #5249115 -UT Exp. 07/01/09 <br />Signature:,.�.� � � �`� �F � X ��� Date: j� r <br />RlF®A-T T <br />AAkULAR <br />4162d Street Galt, <br />56 32 <br />209 Fax209 744-0116 <br />AST TANK TEST <br />Site: ^,. °=, <f ; .,, `fest Date: <br />Address.,,.'' <br />City: x 6 'r'Equipment: <br />Test Method Developed By: <br />Tank Manufacturer Industry Standard Professional Engineer <br />Other (Spec): <br />, <br />Test Method Uses: <br />Pressure - <br />Vacuum Hydrostatic <br />Other (Spec).' <br />Measuring Equipment Used for Testing:f <br />Tank # <br />Tank # <br />Tank # <br />Tank # <br />Tank Ca aci <br />Tank Material: <br />Product Stored: <br />Wait time between applying <br />Pressure/vacuum/ water and starting <br />test: <br />Test Start Time: <br />Initial Reading (Ri): <br />Test End Time: <br />Final Reading (R <br />F' <br />Test Duration: <br />Change in Reading (Rf-Ri): <br />Pass/Fail Threshold: <br />Test Result: <br />, <br />Was sensor removed for testing? <br />Was sensor properly replaced after <br />testing? <br />Ij <br />7. <br />Comments — (include information on repairs made to testing) <br />Technician: Lyle D.* Nimmo ICC #5249115 -UT Exp. 07/01/09 <br />Signature:,.�.� � � �`� �F � X ��� Date: j� r <br />