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JA_ fNKNOLO91 <br />Site Name/Address <br />%�„O r s'ccG�<xr�-�ei1JfC1 �'�, <br />TANKS <br />�'y` CJC�i'iG�C%®C q�o2 l® <br />LINES <br />Attn: <br />Leak Det <br />tillage <br />TANKS and LINES Tested to CFR -40 Parts <br />See <br />Dleg <br />Tank <br />Dipped Dipped Probe Water Bubble <br />Air <br />Line <br />Final <br />Exist 280-281 & NFPA 329 Specs. <br />Dia. & <br />Water Product Water Ingress Ingress <br />Ingress TANK <br />Line Delivery <br />LINE LINE <br />Leak LINE LD(s) NEW <br />For <br />Material <br />Level Level Level Detected Detected Detected, ■ <br />Material Syst. Type <br />TEST TEST <br />Rate ■ <br />Pass/ LD(s) <br />ST/ <br />■ ■ ■ ■ ■ <br />■ Tight <br />■ ■ <br />, ■ ■ <br />■ Tight <br />Fail/ Tested Other: <br />FRP/ <br />START START START <br />or <br />ST/ <br />START END <br />or <br />or & <br />anis Tank Tank <br />Lined <br />END END END Yes/No Yes/No <br />Yes/No . Fail <br />Line # FRP PS/SS/GS <br />TIME TIME <br />GPH Fail NONE PASS <br /># Product Capacity <br />18re18f <br />rte*, yw, 5 zZ 4:e��"'�` <br />w u <br />;'r " <br />r <br />s:� `�; <br />�ri <br />WIT <br />Exist LD SN/MDUMFG: <br />Y, 7 <br />ao <br />x ry <br />w <br />New LD SN/MDL/MFG: <br />l <br />r�y� rcent p at ump <br />Tune: wV Time Test: � Mf <br />UNE TEST PSI <br />C <br />�RSI <br />Of .: <br />inometer <br />Q s valves <br />End Tnirne::/I..dd <br />ecrees:_ . <br />i ^' "*m `° ;r z �".,;., { _ <br />,�£ r° 5.,.x,'3 ,-r"a;a' 5 ' ". <br />Exist LO SN/MDL/MFG: <br />. _ <br />New LD SN/MDL/MFG: . <br />8t <br />t o I at mp <br />StartTime: Time of Test: FAf .. <br />-'z'� <br />r <br />�, <br />- `'"� <br />'". "`lyra, <br />UNE TEST PSI <br />Tank o • - <br />urometer <br />�: . ,.. - <br />. <br />Dispenser Shear Valves <br />End TI T 1• En <br />_ <br />r s <br />Operate /no <br />Diameter <br />AV <br />Exist LD SN/MDUMFG: <br />New LD SN/MDVMFG <br />at <br />rcent o I at _ mp <br />Start Time: Time of Test Mf .: <br />'�`"; -. _ <br />"^ <br />�,- <br />%P <br />:, <br />� � <br />�" <br />�,' � , r� � <br />�„ <br />- <br />LINE TEST PSI . <br />InclinometerThink <br />- ._ _. <br />_. _, <br />DDispenser Ss valves <br />End Time: Test Entrw <br />Decrees: <br />tameter � �r E <br />Exist LD SN/MDL/MFG: <br />...� ..>� <br />�... ., _ <br />E ``z'',..�',', <br />.. <br />New LD SN/MDL/MFG: <br />'99ten <br />.. t o t of mp <br />Start Time: Time of Test: <br />m ... ,,., �+ _ <br />RPRIE <br />'4b ,�,.. <br />,,. �, ,. <br />I LINE TEST PSI <br />urometer <br />� <br />n•. <br />Mspenser Shear Valves <br />n n <br />r <br />e hw <br />TirIameter�r <br />OWNS= <br />�•_ <br />i <br />Exist LD SN/MDL/MFG: <br />.� <br />- <br />- <br />New LD SN/MDL/MFG: <br />IUM ten <br />CBn1 O I at <br />Start Time: ' Time of Test: <br />' , <br />< b <br />LINE TEST PSI: . <br />Tank O <br />inometer <br />Dispenser Shear Vahrea - <br />Erid"nIne: Test PSI: <br />Decrees: <br />operate <br />-. <br />m e <br />r t <br />,. .... . , <br />ra......NOM <br />„.. ,..... , . .. _. <br />.., <br />NEW <br />imam1. <br />. . <br />Exist LD SN/MDL/MFG <br />New LD SN/MDL/MFG:gv - <br />ate <br />gBiFill att <br />steltTime: ^ Time of est: Mf .. <br />"'d z . . : 15 <br />' ak <br />UNE TEST PSI: <br />,. <br />Dispenser Shear valves -- . <br />f <br />Tanknology Corporation International <br />TANKNOLOGY Region: <br />� <br />7 Unit # <br />State LiC. # �/- 110e State: G - <br />_..., <br />77040 <br />5225 Hollister St., Houston" TX <br />WTE: Original VacuTect Data recordir sure reviewed by Tanknol y's Audit Control Department and maintained on file. <br />g 9` og <br />8®®� <br />( ) 888-8563 ® FAX(713)690-2255­, <br />TAK-01 <br />