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AFFORDA-TE$T 416 2nd Street Gait CA 95632 LINE & LEAK DETECTOR <br /> (209) 744-0912 (209) 744-0196 FAX TEST REPORT <br /> CONTRACTOR/ENGINEER TEST DATE <br /> SITE NAME 1 V ' f" )" r �- ,Ga' bz !Y <7 Q PHONE <br /> ADDRESS t J G ' : E I �'' t o N s/ <br /> oY `✓ 1 t+P :iM <br /> Compliance LOCATION SKETCH Show North <br /> Repair/Construction <br /> Insurance <br /> Escrow <br /> Make&Type of Pum or Dispenser <br /> Cover Over Lines <br /> Approx Burial Depth <br /> � ll <br /> Weather <br /> Pressure Suction SHOW STREETS,SLOGS,TANKS,ISLANDS,PIPING(IF KNOWN),PUMPS OR DISPENSERS <br /> Calibrated to 3 gph @ 10 psi FTA LEAK DETECTOR TEST INFORMATION Calibrate <br /> 10 PSI <br /> LEAK DETECTOR KEY wisp#i LD Opening Leak Functional <br /> Time Rate Element Metering <br /> Product Key Serial Number Resiliency In Seconds MLIMrn Holding PSI PSI Pass 1 Fail <br /> A LD 2000 �I do t_ „' r� P ! F <br /> B LD 2000 E <br /> P ! F <br /> C FXI V <br /> D FX1 DV P ! F <br /> E STPMLD <br /> P I I= <br /> F STPMLD-D P I F <br /> G STPMLD - E P 1 F <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 /> Technician:Lyle D. Nirnmo prescribed for as detailed on the test chart on Side 2 of this form with results as follows: <br /> I� .:: LINE IQENTIFICATION <br /> NET VOLUME CHANGE PER HOUR <br /> PETR�,QTITE CERT# <br /> LI P tASSLFAIL <br /> iSSIL 1 INCONCLUSIVE -- rd- <br /> 090993Aa'163 <br /> OTTL Lic#97-1143 •, , /? - / INCONCLUSIVE ��-- <br /> Trainee: PASS 1 FAIL f INCONCLUSIVE <br /> PASS / FAIL / INCONCLUSIVE <br /> EQUIPMENT:PETRO TITE LINE TESTER <br />