Laserfiche WebLink
AFFOFi ® AJE $ T 416 2nd Street Galt CA 95632 LINE & LEAK DETECTOR <br /> [( 209 )09 ) 744 - 0112 FAX ( 209 ) 744 - 0116 TEST REPORT <br /> CONTRACTOR/ ENGINEER ( TEST DATE Q <br /> SITE NAME PHONE ( ) <br /> ADDRESS " 't cj e �, C z► \ moi �1 � , \ � c-( <br /> eN v` 0 <br /> f /Construction LOC TIONSKETCHPA, Show North <br /> Compliance <br /> Insurance b <br /> Escrow <br /> Make & Type of Pump or Dispenser <br /> Cover\dver Lines <br /> Approx Burial Depth <br /> t 44 Weather <br /> Pressure Suction SHOW STREETS , BLDGS , TANKS , ISLANDS , PIPING ( IF KNOWN ) , PUMPS OR DISPENSERS <br /> If 1ww <br /> LEAK DETECTOR FTA LEAK DETECTOR TEST INFORMATION Calibrat <br /> 10 PSI <br /> Opening I Element <br /> LD Serial Time In Test Leak Holding Pass ) <br /> KEY TYPES No/ Product Key Number Resiliency Seconds Rate ML/Min PSI Metering PSI Fail <br /> A LD 2000All <br /> I <br /> B LD 2000 E <br /> C FXI V <br /> D FXI DV <br /> E STPMLD <br /> F STPMLD - D <br /> G STPMLD - E <br /> H STPMLD - D/ E Notes : <br /> CONTRACTOR LINE TEST RESULTS <br /> CERTIFICATION Tests were made on the line systems as noted in accordance with test procedures <br /> prescribed for as detailed on the test chart on Side 2 of this form with results as follows : <br /> Te h i yl R. Nimmo LINE IDENTIFICATION NET VOLUME CHANGE PER HOUR <br /> 6TROTITE CERT# <br /> 090993A01AO163 u PASS FAIL / INCONCLUSIVE <br /> OTTL LIC# 90- 1143 ` q PASS FAIL / INCONCLUSIVE Q 0 ; 0 <br /> Trainee : ) " ee PASS FAIL / INCONCLUSIVE <br /> PASS FAIL / INCONCLUSIVE <br /> EQUIPMENT: PETRO TITE LINE TESTER <br />