HomeMy WebLinkAbout2012 LLD TESTw
N,
RICH ENVIRONMENTAL
5643 BROOKS CT. - BAKERSFIELD, CA 93308
OFF.(661)392 -8687 FAX(661)588 -7808
ACURITE TM PIPELINE TESTER
PRECISION PRODUCT LINE TEST
TEST RESULTS
DATE: 4 -13 -2012
BILLING: A -1 FOOD STORE
1200 "H" STREET
BAKERSFIELD, CA
SITE: A -1 FOOD STORE
1200 "H" STREET
BAKERSFIELD, CA
PRODUCT PRODUCT MECHANICAL
PRODUCTS LINE TEST LEAK DETECTORS
UNL -87 FROM STP TO
DISPENSER 7/8 & 5/6 - .005 -PASS N/A
COMMENTS
A PRECISION TEST WAS PERFORMED ON PRODUCT LINES AT THE ABOVE LOCATION
USING THE ACURITE TM PIPELINE TESTER. I HAVE REVIEWED THE DATA PRODUCED IN
CONJUNCTION WITH AES PROTOCOL, AND THEREFORE SATISFIES ALL REQUIREMENTS
FOR SUCH TESTING AS SET FORTH BY NFPA- 329 -92 AND USE 40 CFR PART 280.
THE RESULTS OF TESTING ARE SHOWN ON THE FOLLOWING PAGE. INCLUDED WITH
THE REPORT ARE REPRODUCTION OF DATA COMPLIED DURING THE TEST WHICH FORMED
THE BASIS FOR THESE CONCLUSION. THIS INFORMATION IS STORED IN A PERMANENT
FILE IF FUTURE VERIFICATION OF TEST RESULTS IS NEEDED.
I DECLARE UNDER PENALTY OF PERJURY THAT 1 AM A LICENSED TANK TESTER IN
THE STATE OF CALIFONIA AND THAT THE INFORMATION CONTAINED IN THIS
at REPORT IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.
TEST ERTIFIED BY:
ES J R CHM#
LMN 245
CERT# 90 -1072
1
ft
RICH ENVIRONMENTAL
5643 BROOKS CT. BAKERSFIELD, CA. 93308
OFFICE (661)392 -8687 FAX (661)392 -0621
ACURITE TM PIPELINE TESTER
TEST RESULTS WORK SHEET
DATE: _ /_ / W/O #:
lit 1r
FACILITY NAME: %t ^ I U (J S'7Uf-wo-
FACILITY ADDRESS: O y S% &tr
PRODUCT LINE TYPE: FIBERGLASS STEEL LASTI (CIRCLE ONE)
SYSTEM TYPE RESSU SUCTION GRAVITY (CIRCLE ONE)
TURBINE MANUFACTURER:
PRODUCT
GRADE
START TIME
INITIAL
READING
00:00 /GPH
END TIME
FINAL
READING
00:00 /GPH
TEST
PRESSURE
P.S.I.
VOLUME
RATE
G.P.H.
RESULTS
PASS
OR
FAIL
PI 5D p os A SS70
I CERTIFY THAT THE ABOVE LINE TESTS WERE CONDUCTED ACCORDING TO THE
EQUIPMENT MANUFACTURERS PROCEDURES. THE TEST RESULTS AS LISTED IS TRUE AND
ACCURITE TO THE BEST OF MY KNOWLEDGE.
THE TEST PASS /FAIL STATUS IS DETERMINED USING A THRESHOLD OF 190 ML PER HOUR,
0.05 G.P.H.), RATE AT l %: TIMES OPERATING PRESSURE, OR50 P.S.I. WHICH EVER IS GREATER,
TECHNICIAN: STATE LICENSE #: qC7 , /0 1? Z
SIGNATURE: MFG. CERTIFICATION #:&-1 y f,Z,a"-/ S
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