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�� ; 4 IE�aJIIIPi�QIEfii'II' • S5�1ESg • I AI.I.A7TII�IY ZIEMVU CIE <br />PET-9+QLEi�[3(1�;EQUI.ME��tfi zaa3 a�r�e�i�: o: mai • :.. u:.:. <br />c zasb.=-tilto ssa <br />CAMPO/HIi.LEt PL400 PIPE LINE TIGHTNESS TESTER <br />Owner/Operator 94/ <br />City, St. , zip : T2,Ve_�, G�7� <br />Site Agent <br />Line Connected to Tank Number/Location <br />Site Address <br />County.Ca/U <br />Telephone -No.: <br />Product Line Dispenses : ,F r Approximate Line Length (in Feet) g; 6?_ <br />Lige Material : E4,e- ,,css Line Has P.L.L.0<es / No <br />Turbine Make %Model Dispenser Make / Model <br />Tank Test Equipment to be in Place During Line Test_ Yes <br />Line -to be Tested With a Line -Block in Place of P.L.L.D. es o <br />Turbine Output Pressure : � 3 P. S, re <br />Time <br />/O <br />InitiaT <br />Final <br />Pressure <br />Pressure <br />Test.Pressure to be a :iLE-L P. S. r. <br />Voitmtie Leak <br />-OispTaced Rate <br />4 3 <br />Average. <br />Leak Rate <br />Using the Campo/Mi 11er PL --400 Pressurized Piping Tightness Testing Equipment and test methods <br />the results as show ow not allow the line to be considered product tight. <br />Final Results : f—�/� G.P.H. <br />Tester��License No. Jam_ <br />Test Date <br />Tester's Signature <br />T <br />PEI <br />r� <br />• oS(itt a::•;E.•JS...i:taOprSw-rr ?::;n�l�:tAt p(pXrwo a •s :<Mr�+iSwc��COma4lSsgrr;sJ. <br />a:C.aSlSt. t? .. - � -•� _:i::' d iN.. w <br />.: <br />r:+r01„I(SSAHM1�r+f,5 - •ao04%tCCv(Rr :.n� -� :.( :C�rr,::1s. �;. <br />'a!h'f rigC.H:. ANO 100-t! <br />_. .. .:nat :;r.,.. iii! - ... .. ter..•.. :.. -. <br />