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Afforda— 1 e —fnamicBack Pressure Test <br /> 416 2nd Street ® TP 20L4 <br /> Galt,Ca.95632 <br /> (209)744-0112(800)524_9087 FAUX(209)744-0116 Static Pressure Decay Test <br /> TP 20].3 <br /> Owner/Contractor/Eng: TEST DATE:5-14-13 TIME:11 UST ® AST ❑ <br /> TECHNICIAN NAME: <br /> SITE NAME:MANTECA EXPRESS ❑PT ❑Startup Test®Compliance Tnt <br /> David A.Winkler SJV#0082 AGENCY:SJV <br /> Address:419 S MAIN STREET <br /> !declare.tarc(er penalry of perjury under rhe laws ojrhe state Inspector. <br /> City:MANTECA CA of California that based on information and beNef farmed <br /> after reasonable ingt&y. the statements and information <br /> Phone: Present C] Not Present <br /> provided in the document are true.accurate,and complete. <br /> Contact:Bobby TECH SIGNA-RRE. <br /> Confirmation#13-16767 <br /> Permit or Facility#N 1159 <br /> #DISPENSERS 2 DISPENSER Make:GILBARCO NOZZLE Make:HEALY PV Valve Make:HUSKY <br /> a 107.4L NOZZLES 4 Model. Model:900 Model:5885 <br /> JLI:VIFO/.DED:Yes® No El BALANCE Lj ASSIST® Assist rape:ISD <br /> Tank Taak2 Taak3 Tauk4 TOTAL <br /> Fuel Grade 87 91 ALL Initial pressure before testing--5.0"we <br /> a Noceles per Tank 4 4 4 E UIPMENT <br /> Actual Tank Capacity 10000 10000 20000 Decay: Blockage: <br /> C.""line N oWene 7461 2618 10079 Incline Manoan t ❑ btctine Manometer ❑ <br /> 2539 7382 9921 htagothehc Guage ❑ Magnebebc Guage <br /> Phase l System Type:2pt EVR Caasia l E V R EVR <br /> Digital Manometer ® Digital Mattometer ❑ <br /> Initial Test Pressure a.—warn vo 2,0 Equipment Calibration Date: 5-1-13 <br /> PSI rn.1 Minute o-—, 2.0 Drift Check End Value: 0 PASS <br /> Nitrogen Intro.Point: 2 <br /> PSI CS 2 Minutes 2.0 <br /> Pst 3 mmme, 2.0 Allowable Fill Time a 2 scan 6m s31 sec <br /> PSI r 4 nlinme. 1 2.0 Time I:2min 12sec <br /> Final Pressure W5 Minutes 2.0 <br /> 1.88 Time 2: <br /> Allowable Final Pressure(GARB) Time 3: <br /> Liquid Removal Check Dynamic Hack <br /> Pressure(ilduel.acid Parts& <br /> ------- ------ ------ ------- PASS Re airs Art I.i".on Page'. <br /> a a2. <br /> DYNAMIC BACK PRESSURE TEST DATA(BLOCKAGE) TECHNICIAN:DAVE WINKLER <br /> Cert#0082 Esp.2012 <br /> Site:MANTECA EXPRESS Date:4-14-13 Time:0 <br /> Norz/Fuel 20 CFH 60 CFH 100 CFH PASSlFAIL No$/Fuel 20 CFH 60 CFH 100 CFH PASSTAIL <br /> Grade (.15"Water) (.45"Water) (.95"Water) Grade (.15"Water) (.45"Water) (.95"Water) <br /> 1-2 .06 PASS — <br /> 34 .04 PASS <br /> LIQUID REMOVAL CHECK '•See Long Form Test Report for Wet Failure Testing Blockage Tester Integrity: <br /> Dry NIA .50"w.c. a 5 minutes PASS <br /> ❑DRY" ❑DRY ❑DRY ❑DRS" ❑DR1" ❑DRY ❑DRY ❑DRI ❑DRI' <br /> ml ml mI ml M ml ml ml ml <br /> ❑DRY ❑DRY ❑DRY ❑DRY' ❑DRI ❑DR1' ❑DRYD❑ ❑DRMI <br /> ml ml oil d ml oil ail <br /> DRI ❑DRI ❑DRY ❑DRl ❑DRI ❑DRY ❑DRI ❑DRl <br /> ml ml nd ml cutndlDRDRlRYDRV DRY DRY DRY <br /> w ml ml ml ml ml ml ' <br /> ml <br /> ® Job Complete Repairs Done to Pass Test: <br /> Not Com fete a <br /> Re irs Still Needed: <br /> Parts: None Drop Tube rings Fill Adaptor Gaskets Hoses Whip Hose <br /> Nozzles I Breakaways PV Valves Others: <br />