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14. lox) Acck�Pc_) 7z�I9 a Name of gupplier,Owner or peeler Add.. Ho.end gtreetfe) City Stet. Data of Test _ 15. TANK TO TEST 15a. BRIEF DIAGRAM FIE D 16. CAPACITY From pl /�/mAj Ror �❑l station Clint r ` �� e hominel Cep..Ry �(il./V lq Tank MenWeetuer's Chart �G7J 3 Ideny by location 1 Gallons ` 5 ❑ Company Engineering Dix:'... S p By moat eocurate / Z ( 11Cherie suppled ad0 Brand end Grade (` .mostly cert aveilebl. - J GO.,. ❑ Other 17. FILL-UP FOR TEST Gallon.' ::atft�mo rn Nor Wain Bottom before FIII-up /Z in. q In. Inventory to'A" Gellona -Tank Diameter 9 rpt 1� 18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK 1, Water in tank Id Until.)being testedwlth LVLLT See manual thel lons applicable.Check below and record procedure In IN(7r. High water table In tank exce+atlon We maximum allowable test pleasure for ell tests.n Trenefn total to Ilne Four pound rule donot apply to Oaublewelled bink!. 19. TANK MEASUREMENTS FOR Complus aeatbn below. TSTT ASSEMBLY 13S 21. VAPOR RECOVERY SYSTEM ❑sager Offt".11 �• Bottmoof tank to grape' ............................ in. Add M'for 7-probe nay........................... 30 b. 24b. COEFFICIENT OF EXPANSION 1. Is lour pound rule reeuirodi vas ❑ la ® Total train ro naembls—e l RECIPROCAL METHOD g approximate............. In. �•�� 1 s�in. .20EXTENSION HOSE SETTING Y0°mPOOu� """ ' """""" """"""""" —t 2.Height to 12"mark from Whom of tank ) /rk Tank top to grade................................... �o In. Hydrometra Empbyed .........................:........ H I F 1/ // n G1 Extend hose on sualon tube e"or more T.mpnature In Tank " 3, pr m H buxom of tank -U / P.S,L bNow tank top...................................... Ann Circulation...............................:........ IF fill 4. Freedom at top of tank / P31. 'If FIII pile extend!above grade,un top of fill. 0 hit? Temperature of Satople........................ ....... . IF O 22. Thnmml-Sensor reeding cher circulation Differaffce('y-)...............'..........................��IF 3 olgxa 0 Depth of burial in. "' 6 Observed A.P.I.Geerrrrityy .../..............................7 7 �in. 29. DI9ibi per IF In route of expected chaeta 6 Reciprocal /7 ( (Q �s 4� Tank die. 9xe o COEFFICIENT OF EXPANSION (Complete after circulation) ?y Z h /y 4G 24a. Corrected A.P.I.Gravity Total quantity In FbolproW V umr on In Witter bible `-� In. full Wk lox or 17) ,. one bank per IF Observed AP.I.Gravity................................... Transfer to Lins 2xit. NOTES Hydromet.r employed ..... ..sits ... ....... H Observed Sample Temperature .. .. ,F 24C. FOR TESTING WITH WATER rTable C a0 o 2 2 Corrected A.P.I.Gravity WOW Temperature Offer Circulation ie WF.From Table A.................................._ Table C................................................ •F -y Coefficient of Expansion Coefficient of Water a.J The aborts calculations aro W be used for dry soll conditions to ler Involved Product Table D........ G7 F� ........................................ Ul') eetaDllsh• effhe reeduroadyant From Table...................._.__....... ........ loo p age,orwlron cess wIn the tank area 10 Companaate for the presence of wbwrlitee wain In the tank Tranafev COE to Line 2%. Added SrdecbiMT 1:1 Yes ❑No hitnaM COE to Uns 2%. ` area. Repay to N.F.P.A. 3Q Sections 2-3.2.4'and 2-7.2 and the tank 25. (a) x (b) a (c) goodsl/� ` + I manulaLlurer regarding avowable eyatsm teat proouree. Total quenny In CeeMici"s of am on In Vdume eneegs in thio to [y /74 ) V tell Wkllan l7) Innvvolob/�eed/[,pyo[/.G ey pn'F - `7q` 102 26. Volmshyss 2/) a Dlpha Dat FI In bat S66 ' Voir s,cnsole per gh 77`� le" V/ / Renta 1231 Compute to 4 decimal o1.. factor(a) �/