Laserfiche WebLink
DATA CHART <br />For Use With <br />pt4ro �t <br />�f 1 of 2 ,mar ►Ldt ' <br />1LOCATION: � v.j- <br />SvNt No. and/Ot Caner City Sale To4onone N. <br />2 OWNER: t" e <br />Nems Adde - Mo.oeemeti♦e P--. TNeo+ane Na. <br />r� <br />3 OPERATOR: - <br />Neme D -w. Mot• of Otnet Add— (N dtNp <br />etent own ►otion) TeUotwne No. <br />R♦ REASON FOR TEST _ -- <br />S TEST REOUESTEO BY: kw <br />Nemo Positi" Otda No. B[" Add... <br />1� <br />6 SPECIAL INSTRUCTIONS: <br />e <br />- <br />7 CONTRACTOR OR COMPANY MAKING TEST - " <br />MECHANICS) NAME \ J 1 ^(f ? (�U / ) n �' L.�-�,J�i�=(� C <br />+� f -rt n : xl l �'�119 V ) <br />8 IS A TANK TEST TO BE OYES 9 MAKE AND TYPE OF y 1 ' '_ ..•�- 1.W- �' b <br />,� f, <br />.: <F <br />MADE WITH THIS LINE TEST) PUMP OR DISPENSERS Q�. <br />U <br />O <br />i 00 <br />t <br />n p r� (; COVER- APPROXIMATE <br />10 WEATHER 4 ` TEMPERATURE IN TANKS _ 'F _ -C OVER LINES "- BURIAL DEPTH <br />Cdnnnte. 6te0 Too. ow. <br />11 IDENTIFY <br />EACH LINE <br />TIME <br />MIAMBIENT <br />13 LOG OF TEST PROCEDURES, <br />TEMPERATURE,✓H <br />RESSURE <br />15 VOLUME <br />16 TEST RESULTS <br />OR kPa <br />E:El- <br />READI <br />NET <br />AS TESTED <br />E�!/2 /) <br />WEATHER, ETC. <br />BEFORE A <br />CHANGE <br />CONCLUSIONS, REPAIRS AND COMMENTS <br />BEFORE <br />AFTER <br />j <br />46 <br />0 310 <br />0320 <br />q 5 <br />0zq:s <br />0z <br />, <br />0 5Ci V — OL000 <br />�GGtP <br />l t bo <br />`l '7 <br />} <br />(23cx.) <br />foGiSC.,'�_ <br />1115 <br />4 itc: <br />I a39v' <br />0 Sas <br />; 0005 <br />f 3U <br />I <br />UU <br />f;ZU <br />0350 <br />1 qC -- 0.7 35 <br />t ZU <br />u <br />ozrf U <br />U Z"3 0- <br />G0 to <br />i 1, . cLZ f <br />1 "s <br />b <br />314 <br />0010 <br />1;0 <br />j <br />46 <br />0 310 <br />0320 <br />f cc t® <br />