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VA LESS MANUFACTURING, INC. <br />LDT-890 Leak Detector Test Record <br />Contractor Customer <br />DIALYSIS NORTH <br />Date Location <br />rLyW(s- T <br />Product <br />7 -2o -Oyu /So/ J-RcC 7B is ,2.) . /Q°P®�/, Coq . 1�/CSc-Z r.4..ge- I <br />Technician ?-• �,SP La'a StT� S 19 - 2 0 <br />A uTo %i/CSrZ <br />Submersible Pump Identification <br />Manufacturer Model No. Serial Number <br />JA-,elcC7— SL/-'e6-•3A4r oLLeG-iBt,C <br />Leak Detector Identification <br />Manufacturer Description Other Style Leak Detector <br />J«7� ACCC 7— Fx / I V <br />Diaphragm -type <br />Piston -type ' <br />SeQtA c.4 - <br />Leak Detector in Submersible Pump <br />Test at Dispenser <br />1. Operating Pump Pressure 37 psi (Purging Test System) <br />2. Gallons per hour rate 3 (Leak Test Phase 1) <br />3. Line pressure with pump shut off 3 L psi (Leak Test Phase 1) <br />4. Bleedback Test with pump off .2YO ml (Bleed -back Test) <br />5. Step -through time to full flow % • 5 G seconds (Step -through Time) <br />6. Leak detector stays in leak search position. (Leak Test Phase 2) Yes <br />3'0zo0 P,??* <br />LEAK DETECTOR TEST <br />Note: Pass = Leak detector stays in slow -flow during GPH test <br />Fail = Leak detector steps through to allow full pump pressure during GPH test <br />Pass <br />Fail 61/L_ <br />*Complete thermal expansion test before failing leak detector. <br />Form 8900 (May 9, 2002) <br />2002 Vaporless Manufacturing, Inc., Prescott Valley, AZ <br />No 4 <br />DIALYSIS NORTH <br />P.O. Box 95 <br />Bella Vista, CA 96008 <br />(530) 275-6667 <br />