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14. 1 Js7 i C.c��x_;}, L tl �=�:.�a 1331 S`r 1�� Inn 1_c» ''n ( >_-Z%- �s Name of Supplier.Owner or Dealer Address No.and Streets) City State Date of Test 15. TANK TO TEST 15a. BRIEF DIAGRAM OF TANK FIELD 16. CAPACITY From P\^ RS ❑ Stettin Chart Nominal Capacity- �� ® Tank Manufacturer's Chart �y +.Identity by Position , Gallons ❑ Company Engineering Data Brand and Grade By most accurate El Charts supplied with capacity chart available I U \ 1 g , ❑ Other Gallons 17. FILL-UP FOR TEST Total Gallons Gallons ea.Reading Stick Water Bottom Debre Fill-up 4E� In. � � In. Inventory to'h"" Gallons Tank Diameter t o—c��.i�� •.S-"sem��k'Y 4" !�. I V 18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK ❑Water In tank ❑ Line(s)being tested with LVLLT See manual sections applicable.Check below and record procedure In log(27). ❑High water table In tank excavation Lite maximum allowable test pressure for all tests. 19TANK MEASUREMENTS FOR Transfer total to line 25a Four pound rule does not apply to doublewalled tanks, . TSTT ASSEMBLY Complete section below: , 2 21. VAPOR RECOVERY SYSTEM ❑Stage I ❑Stage 11 Bottom of tank to grade' ........................... M. Add 30'for-r'probe*say........................... 30.1h. 24b. COEFFICIENT OF EXPANSION 1. Is four pound rule required? Yea ❑ No ❑ g pp RECIPROCAL METHOD Total tubing to assemble—approximate............. in. 20. EXTENSION HOSE SETTING Type of Product.""""""""""'.........v.y..1 2.Height to 12"mark from bottom of tank In. —� Tank top to grade'.................................. In. Hydrometer Employed.................................. H Extend hose on suction tube 6"or more Temperature In Tank ,r y • 3. Pressure at bottom of tank P.S.I. below tank top...................................... In. After Circulation................................... V ll•tl.J, F� Y 1�J 'II Fill i extends above rade,use to of fill. Temperature of Sample............................ F 1. Pressure at top of tank P.S.I. pipe g P 22. Thermal-Sensor reading after circulation Difference(+/-)......................................... •F dipita Depth of burial In. U- ) �� F Observed A.P.I.Gravity Between 23. Digits per IF In range of expected change `2 ; Reciprocal I ( Page e Tank die. In. digits COEFFICIENT OF EXPANSION (Complete after circulation) 24a. Corrected A.P.I.Gravity Total quantity In Reciprocal Volume change in Water table In. lull tank(16 or 17) this tank per•F Observed A.P.I.Gravity................................... Transfer to Line 268. NOTES: Hydrometer employed................................... H Observed Sample Temperature ......................... ,F 24c. FOR TESTING WITH WATER see Table C a D Corrected A.P.I.Gravity Water Temperature after Circulation Q60°F.From Table A.................................... Table C.................I.............................. •F Coefficient of Expansion Coefficient of Water The above calculations are to be used for dry soil conditions to for Involved Product Table D................................................ establishe Positive pressure advantage,or when using the four pound From Table B............................................ rule to compensate for the presence of subsurface water In the tank Transfer COE to Line 25b. Added Surfactant? ❑Yes ❑No Transfer COE to Line 25b. area. Refer to N.F.P.A. 30, Sections 2-3.21 and 2-7.2 and the tank 25, (a) x (b) _ (c) gallons manufacturer regarding allowable system test pressures. Total quantity In Coefficient of expansion for Volume change In this tank full tank(16 or 17) G Involved product per IF 26. (a)ljf `I I t� O t a = ( J C,1.��r. I This Is Volume change per*F(25 or tab) Digits per•F In test Volume change per digit teat Range(23) Compute to 4 decimal places. factor(a)