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;7 <br />ltK I) UU I 'LU M0 1 1 : ZS/51.1 1 :'LU/M bMU�U (1 4 f y <br />Project Name E—a1Z-WWA L &N C L <br />Inspector's Namc QNjL )Q C_ftj <br />L)nit 'rested (5)M u -- wz"' 4 <br />Date _) p -- o_G <br />ANNUAL LCRS GAS TEST INSPECTION <br />Vacuum/blower start time: % 10 Vacuum/blower flow reading: 6—t7 ,n/,,may <br />Docs the: vacuum/blower reading; indicate that the sump is blocked with water? Yes No__X <br />Time <br />Reading (ppm <br />!4/ o <br />> ZSR <br />} <br />MIL <br />4IZ <br />:�' <br />1413 <br />7 <br />qqo <br />�- o <br />20'4 <br />4q1) <br />7 2�irp <br />►ro® <br />� Z- <br />Isiu <br />�U �es4- <br />Time Reading (ntim) <br />Was las detected from the LCRS sump? <br />Comments: <br />Yes No <br />Time Reading (ppm) <br />If No, complete a MWO. <br />Remedial. Action Work Order Date Com letcd Signature <br />Signature of Inspector <br />Page 2 oil <br />