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rhum <br />ttKI)UUI 'LU M0 11:2V� 1-11:2U/NO-bMUbU04 F 6 <br />Project Name E12-k,-AIZD ND LL <br />Inspector's Name SVwL <br />Unit Tested We -ST <br />Date <br />ANNUAL LCRS GAS TEST INSPECTION <br />1. Are all potential conduits sealed properly? yes no <br />2. Do any potential conduits require repair? yes no—\/, - <br />3 <br />'). Tf any of the potential conduits required repair please list- N 11A <br />4. Are any repairs needed to continue gas testing? yes no__)(_ <br />5. Total number of potential conduits that require repair: -�JIA <br />6. 11'repairs are required, complete a Maintenance Work Order (MWO)- <br />Comments: <br />.9UA'D L� 4 kay..4, <br />ft.P� EMINEERING <br />0 <br />(8) GAS INJECTION PHASE <br />Tracer Gas Used: `&M VY LtexA Unit: tvm o - Lues + <br />Start time of tracer gas injection: o-" - Meter Start Reading: E2 9 <br />Stop time or tracer gas injection: i ?- :33 Meter Stop Reading: 62S °J <br />Total volume of tracer gas injected (cubic feet) : 3q - 8 <br />Average flow rate of injected tracer gas(cubic feet per min.): 0 <br />Comments: A �ral- Vq (4tu*-n <br />—7 <br />-(V li-ev /h/ led;" <br />Signature of Inspector <br />Page I of 2 0 <br />