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f • • <br />i <br />Champion Precision Testing <br />PO Box 13059 Sacramento, Ca 95813-3059 <br />(916)927-1557 Fax (916)927-7345 <br />Leak Detector Test Data Sheet <br />Site Name fY/ JA /7 moi_ U A /-(e ✓,��,1Date� j- Y J - dK <br />Test Information <br />Comments: <br />This letter certifies that the annual leak detector tests were performed at the above referenced facility <br />according to the equipment manufacturers procedures and limitations and the results as listed are to my <br />knowledge true and correct. The mechanicai leak detector test pass/fad is determined using a low flow <br />threshold trip rate of 3 gph at 10 PSI. <br />Inspected By: Contractor Champion Precision Testin¢ <br />Veeder-hoot # ;r( ,u l <br />aevimm 5;01 <br />1 <br />2 <br />3 <br />4 <br />5 <br />Product <br />81? <br />Manufacturer <br />lrxcoc:mw <br />Model <br />Resiliency <br />10 v <br />200 <br />.w <br />Opening Time <br />2— <br />Test <br />Test Leak Rate (ml/min) <br />3 <br />Metering PSI <br />3 �{ <br />31 <br />32— <br />PASS or FAIL <br />A5f <br />Comments: <br />This letter certifies that the annual leak detector tests were performed at the above referenced facility <br />according to the equipment manufacturers procedures and limitations and the results as listed are to my <br />knowledge true and correct. The mechanicai leak detector test pass/fad is determined using a low flow <br />threshold trip rate of 3 gph at 10 PSI. <br />Inspected By: Contractor Champion Precision Testin¢ <br />Veeder-hoot # ;r( ,u l <br />aevimm 5;01 <br />