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14. LA N4alb of Suppber,Owner or Dealer ] ,J and Street 1 Ctty Stets Date of Test A 15. TANK TO TEST 15a. BRIEF DIAGRAM OF TANK FIELD 16. CAPACITY From _ l,vF51 WI Station Chart Identity by position Nominal Capacity /0,0 t7 n ❑ Tank Manufacturer's Chart - Gallons ❑ _ _ .-. /w Company Engineering Data _ 3 r ❑ Charts Supplied Brand and Grade By most accurate q p D pplied with capacity chart available I / Gallons ElOther O 17. FILL-UP FOR TEST , Total Gallons rn Stick Water Bottom Gallons ea.Reading aiJ /►� before Fill-up y in. — O _ 9 Lj to S" 6elbnsTank Diameter la Inventory --L•1 /�� 9 c 2 0. =e 18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK ❑Water in tank 04 Line($)being tested with LVLLT See manual sections applicable.Check below and record procedure in log(27). ❑High water table in tank excavation Use maximum allowable test pressure for all test'. 19. TANK MEASUREMENTS FOR 993 G �• Four pound rule does not apply to doublewalled tanks. Transfer total to line 25a 3 / z 21. VAPOR RECOVERY SYSTEM ❑stage IStage 11 DI Complete section below: TSTT ASSEMBLY —e Bottom of tank to grade'...........................: In. Add 30for r probe easy........................... 30 /r+ 1. Is four pound rule required? yes ❑ No ❑ Total tubing to assemble—approximate. 12g In, 24b. COEFFICIENT OF EXPANSION In. RECIPROCAL METHOD 2.Height to 12"mark from bottom of tank ;n, 20. EXTENSION HOSE SETTING Type of Product ..••.'•••••............•.••.............. Tank top to grade'.................................. . y In. Hydrometer Employed........... ., .......... H A 31` Extend hose on suction tube 6"or more 1 3. Pressure at bottom of tank p S I Temperature In Tank ' below tank top........ After Circulation........................................ G s •F in. 00 4. Pressure at top of tank r PSI 'If Fill pipe extends above grade,use top of fill. Temperature of Sample................................. ,F O 22. Thermal-Sensor reading after circulation t Difference �l� �F 3 digits I ........................................ Depth of burial in. ..� �,-.. �� 'F Observed A.P.1.Gravity ............................ 23. Digits per IF In range of expected change / Tank dia. �'�In. dl Ile Reciprocal-14?3Page s COEFFICIENT OF EXPANSION (Complete after circulation) 9130 /q73 , /,1 7 W3 Wil 24a. Corrected A.P.I.Gravity Total quantity In Reciocal Water table . 6=_in. full tank(16 or 17) pr y _ Volume CChangeIn me ..................... Observed A.P.I.Gravity.............. Per IF NOTES: ' Transfer to Line les, Hydrometer employed................................... H i. Observed Sample Temperature ......................... 'F 24c. FOR TESTING WITH WATER ase Table C&D m c Q Corrected A.P.I.Gravity y _ Z ZO mT C � @ 60°F•From Table A.................................... Water Temperature after Circulation �•' �• Table C................................................ •F Coefficient of Expansion Coelflcisnt o1 Water co The above calculations ars to be used for dry loll conditions to Product to for v Positive pressure advantage,orwhen wingthefour pound ed Product establisha From Table B............................................ Table D................................................ rule to compensate for the presence of subsurface water In the tank Transfer COE to Line 25b. O areaAdded Surfactant? ❑Yee ❑No Transfer COE to Una 25b.' Refer to N.F.P.A. 30• Sections 2-3.2.4 and 2.7.2 and the tank 25. (a) x (b) _ (�) manufacturer regarding allowable system test pressures. Total quantity In pallors Coefficient pr of expansion for Volume Chan In th4 tank lull tank(16 or 17) Involved product per•F � / 26. ".-7Yl34U[__ 102 vpMts+e C40 W W rF(p of Rob) ttwwa rer ri b Yet = �O�me!Yk QaZ 4410 Range(27) chanW D«drgli-- - Compute to 4 decimal places, factor(a)