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Customer <br />lork-WorkOrder ■ <br />Customer CompanyCheaper <br />Store John Johnson <br />- •: :. :. <br />golf <br />■ <br />Benicia,r <br />Tracy, CA 95376 <br />707-745-6691�. <br />1) Reason for test: Annual Inspection <br />2) Special Instructions: None <br />3) Is a Tank test to be made with this line test? Yes X No <br />4) Make and Type of pump or dispensers: J�F'q—(J <br />5) Weather. C o ® L Temp. In Tanks: f c Cover over Lines (concrete/asphalt/both) <br />6) Approx. Burial depth of lines <br />11 12 13 14 15 <br />Identify Time Log of Test Pressure Volume Net Change <br />Product (Military) Procedures, PSI of kPa Readings <br />I <br />16 <br />Test Results <br />Conclusions, repairs and <br />Line ambient temp, <br />weather, etc. Before After Before After <br />comments <br />v o 0 <br />069) p <br />R o0 <br />S ® 0O <br />Q <br />D <br />C ® ® 0 <br />Performed by Technician: Lee Reeves State License #90-1124 Test Date: <br />Travis Murphy State License #91-1123 <br />Sacramento EquipMeftth1ahAenaFWe1G0MPanY, Inc. <br />2533 Connie Drive - Sacramento - CA. 95815 <br />916-925-2716 <br />arXcu\t\ptl <br />