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POB 36 26.515 N. SACTO. BL. L j Z & LEAK DETECTOR <br /> as ffYr�`V'�+ ies . F <br /> THORNTON, CA. 95686 <br /> 209 794-01021 800 524-9087 TEST REPORT <br /> CON'I'RACTOR/ENGINEER ���z`'i �t�'�''/ /`�<-' kI<'� TEST DATE <br /> ORDERING TEST <br /> SITE: <br /> OPZRATOR/QI/e'S ,j-/: �I�o�r. talion# OWNER <br /> S1Z>t ADDRI� �- �f7 ADDRESS <br /> PHONE (�D q ) 6�`� ' D PHONE ( ) <br /> ASON FO T T LOCATION SKETCH ;TM `6 H_p p� <br /> UNW)ONLY I rrANK(s)-LDWAS ' 17, ,; p' g` h <br /> 7.-1 �l to <br /> LaaXx)-LEAK DET. t F n <br /> Cl C3 q rl 0 � <br /> TANK(s).LINE(s)-LEAK DET. LTi- =1 <br /> OR DOOMBn C o��J � <br /> covuevslt <br /> LAW <br /> AMOX BURIAL <br /> WFBATHER <br /> PRZMW SUCTION SHOW STREETS BL[XiS TANK ISLAND PIPING F RNOWNL—PUM]PSSOOR DISPENSHRS <br /> LEAK DETECTOR <br /> FTA LEAK DETECTOR TEST INFORMATION <br /> l0 <br /> No. LD Serial a <br /> Number Reslllency a Leak Rate EIa>tent ASI No <br /> YNPS• Pro4d usr In Second, H PS <br /> XLD P/N 116036-6 / R- 3 <br /> AurLD VEL MODEL) f <br /> "M 13"30-5 y D J 06` v D y / ` .3 �/ <br /> a.A� <br /> z <br /> XLP INN 116035-5 <br /> DLD P/N116017.5 V 1'0 ',17°1`f !; / 1 grit _ Qe> 13 <br /> PIN 116012.-5 <br /> HHG 0/07,151701 z l7 <br /> H 'rji�hlklelo Notes <br /> cONTRACTOR LINE TEST RESULTS <br /> CERTIFICATION TES7SOMEMADEONTHELINESYSTEMSASN07 LNACCORDANC9W1711�711ST <br /> PROCF.DURL+SPRESCRIBEDFOR AS DETAILEDON771E78STl:NARPON&=2 <br /> T>iCE 24CM: OF 77115 F0flM WITH RESULTS AS HULLO : <br /> LINK IDENTIFICATION NET VOL C B O <br /> RTA CIRT.N09MU0163 �� PAS / FAIL / INCONCLUSIVE �� <br /> o UC r s1-1t� <br /> 0/,/ PAS / FAIL / INCONCLUSIVE F QC? <br /> TM++�• U PASS / FAIL / INCONCLUSIVE ,n 4'�U <br /> FFAIMtM TiIB <br /> S'^ PASS / -FAIL / INCONCLUSIVE <br />