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Modern Welding Company of Florida, Inc. <br /> 1801 Atlanta Ave <br /> modern Orlando FL 32806 <br /> Fabricators of Metal Products <br /> 407-843-1270 Phone 407-423-8187 Fax <br /> Periodic Interstitial Test Procedure Results <br /> Record of Test <br /> Date: <br /> Tank Size /Identification: <br /> Tank Owner: <br /> Tank Location: <br /> Test Data: <br /> Time duration of test required (See Table 3, in Modern Welding Company's Periodic Interstitial <br /> Test Procedure): <br /> Established vacuum amount (Range 11" Hg +/- 1" Hg): <br /> Initial test time start: <br /> Vacuum amount at end of test: <br /> Test time finished: <br /> Length of test in hours: <br /> Recorded /Tested by: <br /> Company: <br /> Address: <br /> Date: <br /> This record sheet is for informational purposes only and is not meant to be a substitute for any governmental form or submittal. <br />