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0 0 <br /> Champion Precision Testing, Inc. <br /> P. 0. Box 6398, Bakersfield, CA 93386 <br /> (661) 363-7400 Fax (661) 363-7474 <br /> Lic # 848150 <br /> Electronic Leak Detector Test Data Sheet <br /> Site Name__-' &j v rrr ,�' Date / ort; /r <br /> Address <br /> Test Information <br /> 1 2 3 4 5 <br /> Product 15�7 cf r D f 47 CZ- <br /> Manufacturer U dZ /� V(Z <br /> Model 2-s(L'qY�_ z-3 -��.tzv 0 cf*7-7 <br /> `c T��A'GS Tq Sy 5cauy 33 6-.o�z <br /> Line Bleed Back (m]) <br /> Check Valve Folding Pressure <br /> Test Leak Rate (ml/min) (gph) - 3 <br /> PASS or FAIT, <br /> Comments: Q 5- L ^° jiltcF5"'54W - tZ 5 t_-TtL I-e�� <br /> Pec.rtPiA'l /-'a Srf3L V A4LJ'.�F 1? /-- IP :6if-tE , <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 Iimitations and the results as listed are to my <br /> knowledge true and correct. The mechanical leak detector test pass/fail is determined using a low flow <br /> threshold trip rate of 3 gph at 10 PSI. <br /> Inspected By- Contractor—Champion Precision Testing, Inc <br /> Technician 1'I1-ui J 1-, At (L jgIA-3 Veeder-Root# <br /> Service Technician Pr (! -n 9 Y? –-t <br /> S igmature_- -� <br /> RcVmion�"O) <br />