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Na, It Dealer Address No.and Street($) Ciry Stt State Date of Teat 15. TANK TO TEST 15a. BRIEF DIAGRAM OF TANK FIELD 16. CAPACITY From ❑ Station Chart Tm®ST Nominal Capacity_ S®p® R Tank Manufacturers Chart Identity by position Gallons ❑ Company Engineering Data -bleseG Brand and Grade By most accurate Ly o vs/ Q Charts supplied with capacity chart available J G✓ "! ichor Gallons 17. FILL-UP FOR TEST Tota(Gallo Gallons ea.Readkng Stick Water Bottom .(•y, before Fill-up — t M" in. C In. _ Inventory Mohs Tank Diameter 18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK ❑water in tank ❑ Line(s)being tested with LVLLT J ri Me— See manual sections applicable.fleck below and record procedure In k1g(27). ❑High water table In tank excavation Use maximum allowable test pressure for all tests. v Four pound rule does not apply to doublewalled tanks. 19. TANK MEASUREMENTS FOR Transfer total to line 25a 1. VAPOR RECOVERY SYSTEM St Complete section below: TSTT ASSEMBLY 2j C ergs 1 ❑stage 11 Bottom of tank to grade'............................ -- —®--_---..in. t. Is four pound rule required? Yes 1:1 No r Add 30"for" •probe assy........................... 30 in. 24b. COEFFICIENT OF EXPANSION 3 Total tubing to assemble—approximate............. � 3 in. RECIPROCAL METHOD . 6 2. Height to 12"mark from bottom o1 tank ;n_ 20. EXTENSION HOSE SETTING Type of Product........................ ............... m E�°f Tank top to grade'.................................. 97 In. hydrometer Employed.................................. H 3. Pressure at bottom of tankExtend no"on suction tube 6"or more Temperature In Tank — 7 P.SL below tank top...................................... I�� in. After Circulation........... /..J.. .!.®............— 710 -F 4. Pressure at top of tank PSI 'If FlII pipe extends above grade,use top of fill. Temperature of Sample................................. "s"""ue "F 1� 22. Thermal-Sensor reading after circulation Difference(+/-)......................................... •®� •F ?/ {, Depth of burial in. _G digs ® °F Observed A.P.I.Gravity ................................. �J tPrV Between x 23. Digits per'F in range of expected change 3 (,2 — Reciprocala131 Page a 410 Tank rise. in. digits COEFFICIENT OF EXPANSION (Complete after circulation) 45bS"7' -2- , 1.37y0® 24a. Corrected A.P.I.Gravity Total quantity in Reciprocal Volume charge In Water table in, full tank(16 or 17) this tank per'F Observed A.P.I.Gravity................................... NOTES: Transfer to Line 26a. 0 Hydrometer employed.......................... H Observed Sample Temperature ......................... °F 24c. FOR TESTING WITH WATER see Table C Q D Corrected A.P.I.Gravity Water Temperature after Circulation @ 60'F.From Table A.................................... Table C................................................ 'F Coefficient of Expansion Coefficient of Water The above calculations are to be used for dry soil conditions to for Involved Product - Table D............................: establish apositive pressure advantage,orwfen using the four pound From Table6.................... rule to compensate for the presence of subsurface water in the tank Transfer COE to Line 25b. Added Surfactant? ❑Yes ❑No Transfer COE to Lie 25b- area. Refer to N.F.P.A. 30, Sections 2-3.2.4 and 2.7.2 and the tank 25. (a) ��) gallons manufacturer regarding allowable system test pressures. Total quantity in Coefficient of expansion for Volume change in this talk fill tank(16 or 17) Involved product per'F s 26. (a)%t, 37yyo.Lgi.� 3d� = 67 00Z !7 yr Volume change per*F(25 or 24b) Digits per*F in test Volume charge per digit test G®®!y3} rnalce ;x Range(23) Compute to 4 decimal places. factor(a)