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"ARCO Products Company <br />Station # sOW <br />Address <br />Mechanicalleak Detector Test Data Sheet <br />Date - -(X) 19 (]�) <br />Test Information <br />Replaced All Failed Leak Detectors Yes No N/A <br />V <br />If No, Replacement To Be Completed By (Date) <br />This letter certifies that the annual leak detector tests were performed at the above referenced facility <br />according to the equipment manufacturers procedures 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 rate of 3 gph at 10 PSI. <br />Inspected By: Contractor <br />Techniciaj <br />Signature <br />APC -3325 (eine) <br />1 <br />2 <br />3 <br />4 <br />5 <br />Product�� <br />Manufacturer <br />Model <br />L.t��O U)T <br />�rt� <br />Full Operating Pressure (psi) <br />b <br />Line Bleed Back (ml) <br />�C��(,}l..l.. <br />,�•l <br />��jv1v� <br />Trip Time (sec) <br />'� <br />3 <br />Metering Pressure (psi) <br />F/E Holding Pressure (psi). <br />Test Leak Rate (ml/min) (gph) <br />PASS or FAEL <br />Replaced All Failed Leak Detectors Yes No N/A <br />V <br />If No, Replacement To Be Completed By (Date) <br />This letter certifies that the annual leak detector tests were performed at the above referenced facility <br />according to the equipment manufacturers procedures 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 rate of 3 gph at 10 PSI. <br />Inspected By: Contractor <br />Techniciaj <br />Signature <br />APC -3325 (eine) <br />