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• <br />ami <br />Vaporless Manufacturing, Inc. <br />Quality Petroleum Equipment <br />Solutions for Over 20 Years <br />LDT- 890 Test Form & VMI Warranty Checklist <br />October I°', 2006 <br />Test Information <br />Date: ZZ A % I-) TestCompany: <br />Telephone: Contact: <br />Site I.D: GS /25-- Address: !SSv w• J <br />City: Rw_"-- State: 04- Zip: <br />Type of Test Equipment: r f `' T� �-- ✓ <br />Submersible Pump Identification <br />MFG: Model No: <br />Serial No: <br />Leak Detector Identification <br />Jt2 P � <br />MFG: 'V A.��L,n Model No: I b 2`' Serial No: f l y <br />Replacement Leak Detector Identification <br />MFG: '/=*�)_1 1-% 5 Model No: 1 Z ° Serial Nod --11 -1 1 01 O <br />Line Conditions <br />1. Type of Pipe: 2. Diameter of Pipe: 3. Length of Pipe: <br />4. Burial Depth of Leak Detector: 5. Kind of Fuel: 6. Date of Last Line Test: <br />Test Conditions <br />1. Operating Pump Pressure: 2. Gallon per hour test rate: @ 10 psi <br />3. Static Line Pressure (Pump Off): 4. Bleedback Test (Pump Off): c.,� ml. <br />5. Step -through time to full flow seconds (0 psi. to full pump pressure, no leak) <br />6. Leah detector stays in Leak Search Position with a 3 GPH leak - Yes:kPASS No: FAIL <br />7. Was the leak detector adjusted - Yes: No: <br />(See Website - www.vaporiess.com - Technical Bulletin 032805) <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: 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@vaporless.com Web Site: mviv.vaporless.com <br />