HomeMy WebLinkAbout2023 Dispenser Repair (Primary Testing)1ZHVWFR//&
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FINAL TEST RESULTS
ALERT 1000 / ALERT 1050 / TEI LT-3 / VMI LDT-890
CUSTOMER ADDRESS: WORK ORDER: SITE ADDRESS:
TEST DATE:
SITE CONTACT: PHONE:
TECHNICIAN: PHONE: LICENSE:
WATER IN BACKFILL: DATE & TIME OF LAST FUEL DELIVERY:
____________________________________________________________________________
TANK INFORMATION:
(WETTED)TANK 1 TANK 2 TANK 3 TANK 4
PRODUCT TYPE:
TOTAL GALLONS:
PRODUCT LEVEL:
PERCENT FULL:
TEST METHOD:
WATER IN TANK:
TANK MATERIAL:
P.S.I. @ BOTTOM:
TEST DURATION:
FINAL LEAK RATE:
TEST RESULT:
TANK
INFORMATION
(ULLAGE) U/F ONLY
ALERT 1050X ALERT 1050X ALERT 1050X ALERT 1050X
ULLAGE GALLONS:
START PRESSURE:
END PRESSURE:
TEST RESULT:
PRODUCT LINES: TEI LT-3 TEI LT-3 TEI LT-3 TEI LT-3
LINE TYPE:
START TIME:
END TIME:
TEST PRESSURE:
FINAL LEAK RATE:
TEST RESULT:
MECHNICAL LINE
LEAK DETECTORS:VMI LDT-890 VMI LDT-890 VMI LDT-890 VMI LDT-890
MODEL:
SERIAL NUMBER:
CHECK VALVE PSI:
BLEED OFF ml:
LEAK RATE TESTED:
TEST RESULT:
A) These systems and methods meet or exceed the criteria in USEPA 40CFR parts 280, NFPA 329-87 and all
applicable state codes.
B) Any failure listed above may require further action, check with all regulatory agencies.
TECHNICIAN SIGNATURE:DATE: MANUFACTURER CERTIFICATION NO:
Jaco Oil Company
P.O. Box 82515
Bakersfield, CA 9338-2515
132688
01/09/2023
Jaco #7781 Fastrip #22 (South)
4013 South H Street
Bakersfield, CA 93304
Omero Garcua (661)393-7000
Bryan Self (800)339-9930 11-1756
0.00" 24+ hours
87 Unl 91 Unl Diesel
Pressure
7:45 am
8:00 am
65 PSI
0.002
Pass
Pressure
7:45 am
8:00 am
65 PSI
0.002
Pass
Pressure
8:05 am
8:20 am
65 PSI
0.004
Pass
01/09/2023 TMI -146