Laserfiche WebLink
'AFFORDA® <br />416 2nd Street Galt CA 95632 <br />LINE & LEAK DETECTOR <br />(209) 744-0112 (209) 744-0116 FAX <br />TEST REPORT <br />CONTRACTOR/ENGINEER <br />SITE NAME I c-. <br />JAWRf 9009 <br />ADDRESS `7 Ve-� <br />6,1 14 ENVIRONMENT HEAUH <br />PERMIT/SERVICES <br />Compliance <br />Repair/Construction <br />Insurance <br />Escrow <br />LOCATION SKETCH Show North, <br />Make & Type of Pump or Dispenser <br />Y` 4t Vuf Jo' a u m v, <br />eKe <br />Cover Over Lines <br />i <br />Burial Depth <br />Approx <br />Weather <br />SHOW STREETS, BLDGS, TANKS, ISLANDS, PIPING (IF KNOWN), PUMPS OR DISPENSERS <br />Pressure Suction <br />I <br />Calibrated to 3 gph @ 10 psi <br />Ca <br />FTA LEAs( DETECTOR TEST INFORMATION librate <br />10 PSI <br />LEAK DETECTOR KEY <br />Disp # / <br />LD <br />Opening <br />Time <br />Leak <br />Rate <br />Functional <br />Element <br />Metering <br />Product <br />Key <br />Serial Number <br />Resiliency <br />In Seconds <br />ML/Min <br />Holding PSI <br />PSI <br />Pass /Fail <br />A <br />LD 2000 <br />P / F <br />B <br />LD 2000 E <br />P / F <br />C <br />FXI V <br />P ! F <br />D <br />FXI DV <br />p f F <br />E <br />STPMLD <br />p F <br />F <br />STPMLD - D <br />p / F <br />G <br />STPMLD - E <br />p / F <br />H <br />STPMLD - D/E <br />Notes: <br />CONTRACTOR <br />LINE TEST RESULTS <br />CERTIFICATION <br />Tests were made on the line systems as noted in accordance with test procedures <br />Technicia L I D. Nimmo <br />prescribed for as detailed on the test chart on Side 2 of this form with results as follows: <br />LINE IDENTIFICATION NET <br />VOLUME CHANGE PER HOUR <br />PETROTITE CERT# <br />FAIL / INCONCLUSIVE <br />, Li06 C <br />090993AO163 <br />OTTL Lic# 97-1143 <br />PASS / FAIL / INCONCLUSIVE <br />Trainee: <br />PASS / FAIL / INCONCLUSIVE <br />PASS / FAIL / INCONCLUSIVE <br />EQUIPMENT: PETRO TITS LINE TESTER <br />