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V <br />ow% <br />b 1111 <br />Vaporless Manufacturing, Inc. <br />Quality Petroleum Equipment <br />Solutions for Over 20 Years <br />LDT- 890 Test Form & VMI Warranty Checklist <br />October 1", 2006 <br />Test Information <br />Date: Test Company: <?11L <br />Telephone: Contact: <br />Site I.D: Address: <br />City: State:. i# Zip:_ <br />Type of Test Equipment: &11 d '�cv <br />Submersible Pump Identification <br />MFG: f&' - Model No: S7") t1- 5D Serial No: 9j -(-j <br />Leak Detector Identification <br />MFG: Model No: Serial No: &11 fc, <br />Replacement Leak Detector Identification OM <br />MFG: \r"- k-5 Model No: Serial No: / 70 (0 <br />Line Conditions <br />1. Type of Pipe: 2. Diameter of Pipe: 3. Length of Pipe: <br />4. Burial Depth of Leak Detector: 6. Kind of Fuel: 6. Date of Last Line Test: <br />Test Conditions <br />1. Operating Pump Pressure: 2. Gallon per hour test rate: J @ 10 psi <br />3. Static Line Pressure (Pump Off): a.,? 4. Bleedback Test (Pump Off): ml. <br />6. Step -through time to full fl'ow_i_seconds (0 psi. to full pump ` pressur7no leak) <br />11� <br />6. Leak detector stays in Leak Search Position with a 3 G leak -'. es. PASS No: FAIL <br />7. Was the leak detector adjusted - Yes: No; !7 <br />(See Website - www.vaporiess.com - Technical Bulletin 032806) <br />Symptoms <br />1. Won't find 3 GPH leak: 2. Stays In Slow Flow: <br />3. Other: <br />****'** If This Unit Is Returned Under Warranty Please Complete The Following <br />Vaporless RGA#: Return By (Company): <br />Telephone: Contact: <br />Customer Control #: Address: <br />City: <br />State: Zip: <br />Vaporless Manufacturing, Inc. <br />8700 East Long Mesa Drive, Prescott Valley, Arizona 86314 <br />800-367-0185 928-775-5191 Fax: 928-775-5309 <br />Email: vmi@vapot-less.com Web Site: www.vaporless.com <br />