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Champion Precision Testing <br />FO Box 13059 Sacramento, Ca 95$13-3459 <br />(916) 927-1557 Fax (916) 927-7345 <br />Mechanical Leak Detector 'Fest Data Sheet <br />Site Name <br />�CY/1!erd <br />f e <br />Date_j- / 7_-d `f <br />5 <br />Manufacturer <br />Address <br />4f Ll v 7 ' . <br />G,//f d 4-0 <br />Test <br />Product <br />1 j <br />I <br />3 <br />4 <br />5 <br />Manufacturer <br />r P,., -;:o <br />feeder -Root # /2 <br />Model" <br />5rP M c/7 sTPJA,e_ � <br />S imLr7- <br />Resiliency <br />Opening Time <br />2 - <br />Test Leak Rate (mlimin) <br />Test <br />Metering PSI <br />; c� <br />PASS or FAII.a <br />II <br />}4 <br />L <br />4- <br />1 <br />Comments-, <br />This letter certifies that the annual leak detectr tesV were performed at the above referenced facility <br />according to the equipment manufacturers proce&f6 and limitations 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 rare of 3 gph at 10 PSI:. <br />Inspected By: <br />ContractorChampion: <br />Precision Testing, - -- <br />Tecimnician� <br />feeder -Root # /2 <br />Signature <br />RwAjaion Sl01 <br />