Laserfiche WebLink
Ooh No. Customer <br /> Technician /� eD�Q Location <br /> . I. 774/ YM 6's1.a,1fa;w- <br /> License Nei. <br /> Date <br /> Jr — joy q v Citu State <br /> HORIZON LINE TESTING DATA SHEET <br /> 1 2 3 4 S 6 <br /> GRAVE <br /> PUMP TYPE <br /> ISOLATOR <br /> i <br /> PUMP PRESSURE 7 2 10S <br /> TEST PRESSURE <br /> INITIAL LEUEL Q�o 75Z <br /> FINRL LEUEL 015 z Z <br /> TIME STRRTEO 156 13 <br /> TIME COMPLETED f,j,'d <br /> TEST INTERURL <br /> LEAK RATE (GPH) <br /> PASS FRIL PASS FRIL PASS FAIL PASS FRIL PASS FAIL PASS FRIL <br /> ❑ D El El El D D El El El <br /> EXISTING LEAK DETECTOR TEST <br /> MFG. D TYPE <br /> SERIRL <br /> Pass Fail Pass Faii Pass Fail Pass Fail Pass Fail Pass Fail <br /> Test GPH Z ❑ Z ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> Test GPH ❑ :; ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> NEW LEAK DETECTOR TEST <br /> MFG. D TYPE <br /> SERIRL <br /> Pass Fail Pass Fail Pass Fail Pass Fail Pass Fail Pass Fail <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> AFTER TESTING <br /> Pump & Yes No Yes No Yes No Yes No Yes o Yes No <br /> Dispenser I�1 <br /> Operational ❑ ❑ El El ❑ 1:1 1:1 1:1 <br /> t I uerify that the dispenser (s) work normally and that the leak detect {s) are not leaki <br /> Field Notes MGR Signature __ <br />