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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 /f��y• ,4i/ ❑ Station Chart � -r I "_ ~%� "T Nominal Capacity Tank Manufacturer's Chart Identity by 1po1sitiioonGallons! - �u1u T��. -:"' �./�s tl' 3 �Wift> ❑ Company Engineering Data Brand and Grade \ By most accurate �'7 ❑ Charts supplied with ht4ttJ'�1,1 r1 k`J capacity chart to � ❑ Other Gallons 17. FILL-UP FOR TEST Total Gallons Gallons ea.Reading Stick Water Bottom M /� before Filt-up � In. �� In. Inventory to W, Gallons Tank Diameter 18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK ❑Water in tank ❑ Line($)being tested with LVLLT See manual sections applicable.Check below and record procedure In tog(27). ❑High water table In tank excavation Use maximum allowable test pressure for all tests. 19. TANK MEASUREMENTS FOR Transfer total to line 25a Four pound rule does riot apply to doublewalled tanks. Complete section below: TSTT ASSEMBLY 21. VAPOR RECOVERY SYSTEM ElStage 1 ❑Stage 11 Bottom of tank to grade'............................ I I In. Add 30"for'T'probe easy........................... 30 In. 24b. COEFFICIENT OF EXPANSION 1. Is four pound rule required? Yes ❑ No ❑ Total tubing to assemble—approximate............. In. RECIPROCAL METHOD 20. EXTENSION HOSE SETTING Type of Product........................................ 2. Height l0 12"mark from bottom of tank In. t Tank top to grade'.................................. In. Hydrometer Employed.................................. Extend hose on suction tube 6"or more Temperature In Tank r / 3. Pressure at bottom of tank P.S.I. After Circulation........................................ 4'-%9 •F belowtank top...................................... In. Temperature of Sample................................. •F 4. Pressure at top of tank P.S.I. 'If FIII pipe extends above grade,use top of fill. 22. Thermal-Sensor reading after circulation 144Difference(•/-)......................................... •F / / dig/its' Depth of burial In. 1440` u ` •F Observed A.P.I.Gravity ................................. Between 23. Digit.per•F In range of expected change � -a Reciprocal Page s Tank die. In. digits COEFFICIENT OF EXPANSION (Complete after circulation) 24a. Corrected A.P.I.Gravity Total quantity In Reciprocal i Volume change in Water table In. full tank(16 or 17) this tank per•F NOTES: Observed A.P.I.Gravity................................... Transfer to Line 26a. Hydrometer employed................................... H Observed Sample Temperature ......................... °F 24c. FOR TESTING WITH WATER see Table C&D Corrected A.P.I.Gravity Water Temperature after Circulation 60°F,From Table A.................................... Table C 6412— F Coefficient of Expansion Coefficient of Water v'v�. - The above calculations are to be used for dry soil conditions to for Involved Product Table D.................................. ...... "^�'�) establish a positive pressure advantage,orwhenusingthefourpound From Table ............................................ 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. 34 Sections 2-3.2.4 and 2-7.2 and the tank 25. (a) ;[0(t O aQ x (b)r (c). E�f ' 3 to manufacturer regarding allowable System test pressures, �Q gallons fl fl Y Q Total quantity In Coefficient of expansion for Volume change In this tank full tank(16 or 17) Involved product per•F 26. (a), ;:41 CQ 13(:p 3Z.Cp = bbC�CII�$C�' rnla Is Volume change per'F(25 or 24b) Digits per•F In rest Volume change per digit test Range(23) Compute to 4 decimal places. factor(a)