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Champion Precision Testing. <br />PO Box 13059 Sacramento, Ca 95813-3059 <br />(916) 927-1557 Fax (916) 927-7345 <br />Mechanical Leak Detector Test Data Sheet <br />Site Name o FZA 9 , —a(jJ o�—Fzle t Date t I - ( — C y <br />Address 4-A 1� L ✓r3 �✓ > t4 <br />Test information <br />Comments: <br />This letter certifies that the annual leak detector tests were performed at the above referenced facility <br />according to the equipment manufacturers procedures and limitations and the results as listed are to my <br />knowledge true and correct, The mechanical leak detector test pass/fail is determined using a low flow <br />threshold trip rate of 3 gph at 10 PSI. <br />Inspected By: Contractor Chamgion Precision Testing <br />Technician nn 4c Veeder-Root # f Z <br />Signature <br />Revision 5.,,0 1 <br />1 <br />2 <br />3 <br />4 <br />5 <br />Product <br />Manufacturer <br />Pe-Tiv <br />Fe <br />- P= -Tri <br />Model <br />S7'f� ele-n <br />5 —1/0 <br />Resiliency <br />Ire) <br />I <br />Opening Time <br />� <br />Test Leak Rate (ml/min) <br />(gph) <br />Metering PSI <br />2,q <br />76 <br />'30 <br />PASS or FAIL <br />Comments: <br />This letter certifies that the annual leak detector tests were performed at the above referenced facility <br />according to the equipment manufacturers procedures and limitations and the results as listed are to my <br />knowledge true and correct, The mechanical leak detector test pass/fail is determined using a low flow <br />threshold trip rate of 3 gph at 10 PSI. <br />Inspected By: Contractor Chamgion Precision Testing <br />Technician nn 4c Veeder-Root # f Z <br />Signature <br />Revision 5.,,0 1 <br />