Laserfiche WebLink
TECHNICIAN p` CUSTOf�1ER <br /> DATE LOCATION Z1,0 A1, <br /> g5zO <br /> TIME, TESTING <br /> HORIZON LEAK DETECTOR TESTING DATA SHEET <br /> PRODUCT ani sF,, !- L <br /> EXISTING LEAK DETECTOR TEST <br /> MFG.& TYPE / <br /> SERIAL lom-S J <br /> PussFail Pass Fnil Pza=.s Fail Pv:::; Fail PLSS Fail Pass FL+l <br /> Tast GPH El ❑ ❑ El ❑ El El 11 1:1 ❑ <br /> P.a s F,�.i i':55 Foil Pass Fa,l Pass Fail Puss Feil Pz-Ss F ii <br /> Test GPH ❑ 0 ❑ ❑ ❑ ❑ 0 ❑ ❑ ❑ ❑ <br /> NEW LEAK DETECTOR TEST <br /> tviFG,& TYPE <br /> SERIAL N <br /> Pt F-:l Pass Fad PZ,-.S Fail PaEs Fail PaS= F it Pass F=ail <br /> El ❑ ElEl ❑ ElEl ❑N El ❑ <br /> AFTER TESTING <br /> Pump & yas No Yes No Yes No YL:; No Yc-S No Yes No <br /> Dispenser ( ❑ ❑ ❑ ❑ El El ❑ ❑ ED <br /> I verify that the oispenser(s) work normally Gnct that the leak di:tector(s) are not leaking. <br /> MGR signature <br /> MELD NOTES <br />