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N 9� �1 o c c c D. d m m m m m Cl d o a 0 CC U O U Od w + 00 Wy m W co o m o �l m r Co y ti m N N yV\ \ m z g mcGUwW O L > E m m¢ d o 8 �- ° Uo = 3 IF 6 V m EE ¢ rnf _ E E m 00 9 U c Z Z aai aai >, o ii 0 O Q Q \\ a y m v � 0 a a m *+10 � = co g" Z � Z M o W :049m v my 02 O V \ 1 H V a VVV z O 0 o p am COD m a � W U m Z .. d to v m Q = n o y 0 r c: to a t 7 f o 0 ° ° y yoIEEE y - C « . i L\ C n 01 E E ¢ v m 3 O O Q 'qC aS NM o y W0 �� 0 0 ¢ ¢ ¢ \ ¢ m u. V) p 3 o m y L ppV (a� 0 3 ma �'V 3 a " °+ L V E a CE o E = w v + o � m ~ Ym o d p Y O y ® M= JO DID t t` m W `y o E_ m m MC J m o ° an d p ccOU a v a. .. 9 c 41 m y. 3m 0 U Z'g E E o U 10 .. 0 3 o L c '0" 10 a a _ O C C C `U L g a U o 0 0 N N tl! W c ,L ,c 0. c o m m c F Z E ` E +� E y o `o ¢ m o VN Z J� Z a2 Z r• , ,Ib Z O Fes- w Fo- ° Q H r_ 1, r U Cki U ❑ ❑ VD D H w W W Y p � Z Cn Z 0 F Q CD w J O W m O Y Y H E o_ O 3 p0 o Q W I— U .c QQ Cn CMD d Z W Z Ii W Z Z ° p J CD d Cr CAD Q Z °o W C:) ore O 2Q OC Q CC W - � Z Cr N � m O � Y m m Ha W = Q = L d 2 �uni � N ZC= t] z° rn CL w Q Cn a 2 N Z m E N ~ 0 J Z U o — H � W w LU W IZ W W x W Q o Q zQ J 2 O W �, > OZO H CnU M rA O O CC H W � lw - H � � Z Q O � LL, LU r fV 7 C `7 L6 CO c6 r r IL 14 , S/lY � SlIz Name of Supplier, Owner or Dealer Address No. and Street (s) City State Date of Test 15 , TANK TO TEST 15a . BRIEF DIAGRAM OF TANK FIELD 16 , CAPACITY From /1 ,t 1 � S' � "' �" ^�- ❑ Station Chart or sjl ail /i !1? � vV .` Nominal Capacity � ✓ ' n 0 Tank Manufacturer's Chart Idenfify position �- Gallons ❑ iCompany Engineering Data rt "6:7 '� 'Ed ) ❑ Charts supplied with ca Brand and Grade most accurate / / / 2 T ❑ -�-� capacity chart available CO V [J Other Gallons 17 . FILL UP FOR TEST J Total Gallons Gallons ea. Reading Stick Water Bottom - ! ) / before Fill-up to in. in. Inventory " i � / / L/"w� to 'A Gfillons Tank Diameter - 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 - � ! Use maximum allowable test pressure for all tests. 19TANK MEASUREMENTS FORTransfer total to line 25a . Four pound rule does not apply to doublewalled tanks. TSTT ASSEMBLY Complete section below : 21 . VAPOR RECOVERY SYSTEM ❑ Stage I ❑ Stage II Bottom of tank to grade' . . . . . . . . . . . . . . . . . . . . . . . . . . . . / in. Add 30" for "T" probe assy.. . . . . . . . . . . . . . . . . . . . . . . . . . . 30 in. 24b , COEFFICIENT OF EXPANSION 1 . Is four pound rule required? Yes ❑ No ❑ Total tubing to assemble — approximate . . . . . . . . . . . . . in. RECIPROCAL ,METHOD 45 2. Height to 12" mark from bottom of tank in . 20. EXTENSION HOSE SETTING Type or Product 1 ' 11 ' 1 . . ' .'411111111111111111111111111111 Tank top to grade' . . . . . . . 1 . 1 . . . . . . . . . . . . . . . . . . . . . . . . in. Hydrometer Employed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . `0 H Extend hose on suction tube 6" or more Temperature in Tank 441 c � ° 3. Pressure at bottom of tank P.S. I. After Circulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ✓ ' F below tank top . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . in. Temperature of Sample . . . . . . . . . . . . . . . . . . . . . . . . . . . 1110 . . OF 4. Pressure at top of tank P.S. I. 'If Fill pipe extends above grade, use top of fill. 22 . Thermal-Sensor reading after circulation �� Difference (+/-) fL ° F . . . . . . . . . . . . digits Depth of burial in. yt/f ° F Observed A. P. I . Gravity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _.S„?v• (� Between 23 , Digits per OF in range of expected change 23_ ./ Reciprocal ; l Page If v v Tank dia. in. digits O *_ COEFFICIENT OF EXPANSION (Complete after circulation ) J / (� ''' � _ _ / 24a . Corrected A. P. I. Gravity Total quantity 'in Reciprocal Volume change in Water table in. full tank (16 or 17) this tank per OF Observed A. P. I . Gravity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Transfer to Line 26a. NOTES: Hydrometer employed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H 24c . FOR TESTING WITH WATER see Table C & D o � D Observed Sample Temperature . . . . . . . . . . . . . . . . . . . . . . . . . OF Corrected A.P. I . Gravity Water Temperature after Circulation @ 600F, From Table A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Table C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . 0 . . . . 0 . 0 . . . . OF Coefficient of Expansion Coefficient of Water The above calculations are to be used for dry soil conditions to for Involved Product Table D, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . establish a positive pressure advantage, orwhen 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 2-3.2.4 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) involved product per OF 26 , ( a) /h This is Volume change per OF (25 or 24b) Digits per OF in test Volume change per digit test Range (23) Compute to 4 decimal places. factor (a)