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NTCA TEST DATA FORM <br />Location Name: I FL y //.Jd:- -r I Location #: <br />Address: <br />/S01 W T, ez T.vE R.� <br />TesiDate: <br />7 -2 v - o 5/ <br />7 —2 /-O <br />City!St!zip: <br />CA . <br />Testing Co/Tech: <br />YInrCE aT- <br />AJE <br />Weather: (T e) <br />&6-A a N16-107-- 70 0 <br />UNES <br />Line # <br />I <br />2 <br />3 <br />4 <br />5 <br />6 <br />Product: <br />j�, E svZ <br />A /e s� L <br />l�,t•.s E� <br />87 <br />07 <br />`� l <br />Line ID: <br />% 19-ZOrX <br />4/!P. -2/-25 <br />AIP. 24.fl,Q <br />D/5e- -✓Z <br />0/SP• /2 /7 /g <br />AISP /-/Z <br />Type: <br />Pres / Suction <br />/ Suction <br />/Suction <br />Suction <br />Suction <br />Pnessur t Suction <br />Size (in): <br />3 e. L y <br />3 to/ <br />2. <br />3 to 2 If <br />21% <br />2 <br />Approx Length (ft): <br />le.0 / <br />7,57 " <br />Za0 " <br />'210 <br />7ZO / <br />25iD <br />Line Material: <br />(J�S/Xor <br />©/S/?CorF(DS/Xor <br />- <br />©S/Xor <br />Q�o/S/Xor <br />(DS/XoF <br />Is Flex Connectors: <br />/0 <br />/7 <br />/7 <br />Cover Over Line: <br />6OA g <br />ca -i /z417i- <br />LO RK° /G e7'ler <br />CO j R Gr%� <br />Leak Detector Type: <br />e ' <br />arc <br />c <br />ectr weic <br />ecuuri <br />c <br />ectronic <br />Pump MfS- <br />JP , <br />.? S <br />/2 J- <br />l 7- <br />R11— <br />/,T- <br />TUig <br />DispenserMfg: <br />G/L�SA/zCC7 <br />G/��.r�G'a <br />i. 'c /3s4i1C'v <br />�/t �F,�oo <br />/LBAReo <br />(r-1c/j/1FZ <10 <br />Isolation 0 PuW. <br />/HPACr' OILvt <br />I A-poCT VA <br />//'�PRcT IIAUJ6 <br />/`ti/jd' (ftV <br />IVO(! Jol <br />/ty 4e VAL <br />Isolation (it Dispenser: <br />60elL l'/1►ar/F' <br />ALL V4' -VC- <br />I L. <✓f- <br />J34 u VA[e/C <br />GAIL 1141-Ve <br />644L VALV <br />Test Pressure (psi): <br />O <br />60 P5-,- <br />56 Yek, <br />.10 <br />Sol l <br />Tea Start Time: <br />®; 3 0 <br />0/1,45 <br />23 1,00 <br />03 : 3O <br />0/111S <br />23 v v <br />Test End Time: <br />Dlo -55 <br />0Y;0 <br />0 / .'2D <br />O /:05 <br />Net Volume Chg (gph): <br />; oo L 5 6,011 <br />-.0090 GP/{ <br />' ; 0090 6PI^4 <br />0,210 G R14 <br />'-. O a g S 6P <br />- gap 6A14 <br />Meets Criteria: <br />PAS FAIL <br />PAS FAIL PASS AIL I PAS / FAIL <br />CAIL, S <br />All, <br />PAS AIL <br />Product: <br />-z <br />D lC S e Z. <br />n!E st L, <br />67 <br />6°Cl <br />g l <br />Make: <br />k, <br />cT <br />,of , Pt-7VFGo <br />. Pc;'90 <br />- ,c7 RJ <br />lar Pt720 <br />Model: <br />FW/1) ✓ <br />/0X/ v <br />P- /yv�- <br />I0/ s s7 S/ <br />�i /) . <br />-(� /''hL/� <br />Full Oper. Pressure: <br />(Psi) <br />37 ®-r l <br />36 /'sl <br />3 PS <br />Z7 PS/ <br />24 s�S. <br />29 Pl/ <br />Opening Time (seconds) <br />/ , So Set:�r <br />/, -V 3 SPCS <br />S 7 <br />L% ',,17 <br />Funs Eleni Holding <br />(Psi) <br />.36 PS/ <br />PS / <br />/3 PS/ <br />13 PS <br />�S mss/ <br />Biped Back (ml) <br />290 h L <br />32o of L. <br />Z (o S P• <br />.? /v h/ L <br />15' 5 A, / <br />•Z t3S <br />Metering Pressure (psi) <br />2Z PS / <br />2 S P-r <br />Z o Ps <br />/I PSI <br />/3 -- <br />y Ps <br />Irak Rate (gMw) <br />3 GP/ / <br />Result: <br />PASVIF L <br />PASS AIL <br />PASS <br />PASS All, <br />PASS L <br />PAS FAIL <br />TANKS <br />Tank Testing Method: <br />/SOT TE STE <br />Tank ID: <br />Type: <br />P/ S /VAT NUP <br />P/ S NAT NUP <br />P/ S /VAT NUP <br />P/ S /VAT NUP <br />P/ S /VAT NUP <br />P/ S /VAT NUP <br />Size /Gallons: <br />Diameter: <br />Ground Water Frown <br />Grade ft : <br />Product Level (in): <br />Liquid leak Rate: <br />(GPH): <br />Liquid Resatt: <br />PASS / FAIL <br />PASS / FAIL <br />PASS / FAIL <br />PASS / FAIL <br />PASS / FAIL <br />PASS t FAIL <br />Ullage Result: <br />PASS / FAIL <br />PASS / FAIL <br />PASS / FAIL <br />PASS / FAIL <br />PASS / FAIL <br />PASS J FAIL <br />