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Champion Precision Testing, Inc. <br /> P. 0. Box 6398, Bakersfield, CA 93386 <br /> (661) 363-7400 Fax (661) 363-7474 <br /> ic. # 848150 <br /> Mechanical Leak Detector Test Data Sheet <br /> Site Name % Date /� <br /> Address %�5�� S •t�,r�i-, <br /> Test Information <br /> 1 2 3 4 5 <br /> Product <br /> Manufacturer <br /> Model <br /> Resiliency <br /> Opening Time <br /> Test Leak Rate (mi/min) <br /> ph <br /> Metering PSI <br /> PASS or FAEL <br /> Comments: <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 PSL <br /> Inspected By: Contractor Champion Precision Testing, Inc. <br /> Technician .� �G�J�« Veeder-Root <br /> Service Technician d, % <br /> Signature <br /> RPvicin»smi <br />