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'Champion Precision Testing, Inc. <br />PO Box 13059 Sacramento, Ca 95813-3059 <br />(916) 927-1557 Fax (915) 927-7345 <br />Site Name / /fc O <br />TS 1000 Mechanical Leak Detector Test Data Sheet <br />Date i0 Ll qiC Y <br />Address �a v � , C�� •rz� K��,� L,v C, r ?�, c ��. <br />Test Information <br />Product <br />Leak Detector <br />Model <br />Serial Number <br />Line <br />PSI <br />Seating <br />PSI <br />Slow Flow <br />PSE <br />Flow Rate <br />@ 10 PSI <br />Resiliency <br />Pass or <br />Fail <br />�. <br />'57P -MLD <br />010100>c <br />-2`1 <br />22 <br />1z <br />1 SC-� <br />r(. -v.3`7 <br />�2o?F:3 33iS" <br />Z 7 <br />�`( <br />iO <br />3 <br />5c� <br />2 -7 <br />Comments: aA.1 <br />This letter certifies that the leak detector test(s) were performed at the above referenced facility according to the <br />equipment manufacturers procedures and limitations and the results as listed are to my knowledge true and <br />correct. The mechanical leak detector test pass/f" is determined using a low flow threshold trip rate of 3 gph at <br />10 PSI. <br />Inspected By: Contractor Champion Precision Testing, Inc <br />Technician f-J,� G �r rLL�4FZry <br />Date %C/i vo <br />SignatureL��/�1��� t <br />Time 0 <br />Revision 5/01 <br />