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Project Name F-0 RWOOL) LAW DRQ, . $iVALUEInspector`s Name SV N i,L S14 J�1 . ENGINEERING <br /> Unit Tested WAI IJ- "WC.ST <br /> Date - 2 t 0a <br /> ANNUAL LCRS GAS TEST INSPECTION <br /> (A) PRI!,-TEST INSPECTION <br /> 1. Are all potential conduits sealed properly? yes---g- no <br /> 2. Do any potential conduits require repair? yes no__X_ <br /> 3. If any of the potential conduits required repair please list: IVA <br /> 4. Are any repairs needed to continue gas testing? yes no__X_ <br /> 5. Total number of potential conduits that require repair./L/0_� 2, <br /> G. If repairs are required, complete a Maintenance Work Order(MVVO). <br /> Comments: V v x&y v��`ly— h�j � <br /> .- ` <br /> vv_ <br /> (B) GAS INJECTION PHASE <br /> Tracer Gas Used: s Unit: Gt/ 1 U--6U04 <br /> Start time of tracer gas injection: ��,3 Z Meter Start Reading: 776 <br /> Stop time of tracer gas injection: 12-10 Meter Stop Reading: 791 <br /> Total volume of tracer gas injected(cubic feet) : ' 5-• C <br /> Average flow rate of injected tracer gas(cubic feet per min.): 0 <br /> Comments: A '1y4c wu.. <br /> e <br /> Remedial Action Work Order Date Completed Signature <br /> Signature of Inspector <br /> Page 1 of 2 <br />