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,SWR.CB, January 2002
<br />7. -DISPENSER CONTAROMNT
<br />fest Method D 1 d
<br />WM-I UP17, e
<br />Page 5 of
<br />1 es ❑ No ❑ NA I 'KYes ❑ No ❑ NA I F Yes ❑ No ❑ NA I WYes ❑ No ❑ NA
<br />verified functional after testing?
<br />Comments - (include information on repairs made prior to testing and recommended follow up for failed tests)
<br />/11 I ;ZPv,r-I, rr - ov, 5 ,,,� �-M ,, Lb4-1 # - (is � n t� C'.` s ,
<br />1 If the entire depth of the UDC is not tested; specify how much was tested. If the answer to ppX of thequestions indicated with an
<br />asterisk (*) is "NO" or "NA", the entire UDC must be tested. (See SWRCB LG -160)
<br />eve ope By.
<br />u UL)u Manutacturer ❑ Industry Standard b.Professional Engineer
<br />❑ Other (Spec)
<br />Test Method Used:
<br />❑ Pressure
<br />❑ Vacuum
<br />- ja Hydrostatic
<br />❑ Other (Spec)
<br />Test Equipment Used � � � �"� � 4 �lG^Equipment � n { �- a �
<br />{
<br />Resolution.
<br />i
<br />P.A
<br />UDC # l i
<br />UDC # f.t
<br />UDC #` r,.,..
<br />UDC Manufacturer:
<br />UDC #
<br />UDC Material:
<br />v o13
<br />c
<br />rAvo <� ;ec
<br />o
<br />(,; c t - r- 4
<br />vd
<br />UDC Depth:
<br />«
<br />O.1
<br />.
<br />k .�
<br />ec.
<br />Height from UDC Bottom to Top
<br />of Hi est Piping Penetration:
<br />-P e c_ h , , -1
<br />�, c �, '
<br />see C o
<br />Height from UDC Bottom to
<br />Lowest Electrical Penetration:
<br />,-r n K- 0, c
<br />C p ILA A,�G,�1
<br />Condition of UDC prior to
<br />testing:
<br />-.
<br />_
<br />Portion of UDC Tested
<br />Does turbine shut down when
<br />UDC sensor detects liquid (both
<br />product and water)?°
<br />❑ Yes ;RNo ❑ NA
<br />❑ Yes oto ❑ NA
<br />❑ Yes j o ❑ NA
<br />❑ Yes? o ❑ NA
<br />Turbine shutdown response time
<br />Is system Y programmed for fail-
<br />safe shutdown?`
<br />❑ Yes 5 -No C1NA
<br />❑ Yes ❑ NA
<br />❑ Yes Ao ❑ NA
<br />❑ Yes �To ❑ NA
<br />asrefai verified to be
<br />❑ Yes ❑ No
<br />r
<br />o nal?
<br />)dNA
<br />❑ Yes ❑ NoA
<br />f �N
<br />❑ Yes ❑ No �NA
<br />❑ Yes ❑ NO AA
<br />Wait time between a lying
<br />pressure/vacu wat and
<br />starting test
<br />( y` : 4 S
<br />J vis G , r =c S`
<br />10
<br />Test Start Time:
<br />7 ; U
<br />7
<br />3
<br />s'
<br />Initial Reading
<br />Test End Time:
<br />w ' r
<br />-i- r,. (_
<br />Final Readingc
<br />. 471 c �, t.
<br />v + c:
<br />Test Duration:
<br />a in Readin (RF- :a R)
<br />t"
<br />,.,Chan
<br />r
<br />Threshold or Criteria:nti,�
<br />�.Pass/Fail
<br />9-,_
<br />Results
<br />, ._:Test
<br />Pass ❑ Fail
<br />Pass ❑ Fail
<br />q Pass ❑ Fail )aPass ❑ Fail
<br />Was sensor removed for testing?
<br />-
<br />)es ❑ No ❑ NA )d Yes ❑ No ❑ NA
<br />Yes ❑ No [INA
<br />Yes ❑ No 11 NA
<br />Wae ePrlenr rrn -A , .0..1.,..,.,7 _—,
<br />__.
<br />1 es ❑ No ❑ NA I 'KYes ❑ No ❑ NA I F Yes ❑ No ❑ NA I WYes ❑ No ❑ NA
<br />verified functional after testing?
<br />Comments - (include information on repairs made prior to testing and recommended follow up for failed tests)
<br />/11 I ;ZPv,r-I, rr - ov, 5 ,,,� �-M ,, Lb4-1 # - (is � n t� C'.` s ,
<br />1 If the entire depth of the UDC is not tested; specify how much was tested. If the answer to ppX of thequestions indicated with an
<br />asterisk (*) is "NO" or "NA", the entire UDC must be tested. (See SWRCB LG -160)
<br />
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