HomeMy WebLinkAbout12729 009493 101 12-23-2020 LDLTTEST SLA LINE AND LEAK DETECTOR TEST 70638.25 c LDLTTEST
DRAFTADEM
AUTOMATIC LINE LEAK DETECTOR (ALLD) and LINE TIGHTNESS TEST REPORT
Facility Name: r/ & S I Owner:
Address: Address:
City,County,Zi : a34,16,r City, State Zip: _
Facility I.D.#: JZS1111 Phone#:
Tester Name:Christopher Hod Dempsey Tester Phone#:206-339-3535
Tester Certification: Estabrooks Ezy Chalk CertificationExpiration: 03 131 /2021
Tester Company:Quality Tank Testing Test Date:
Instructions
'
1. Submit this form,attach all last date for every test performed,and submit a completed copy of this form to: Groundwater Branch,PO
Box 301463,Montgomery,AL 36130-1463,or fax to: (334)270.5631.or email to: USTcomoliancGOarlam.alabama.00v. This form
must be completed and Included with the test data or the submittal will Trot be accepted.
2. This tone allows up to 6 ADEM Unique Tank Numbers,assuming that the Facility ID Number and test equipment remain the same.
3. Testing must be performed in accordance with a nationally recognized code of practice(such as PEI RP-1200 or equivalent)or the
manufacturer's instructions.
4. Line tightness test equipment used must be approved by ADEM. Visit the NWGLDE websm at www..glde.om to view a list of
release/leak detection equipmenilmethods that ADEM approves for use in Alabama.
5. Automatic Line Leak Detectors are designed to be tested in-place. Do not remove and test outside of the tank system.
6. Keep a copy of this testing for 3 years. Questions on how to complete this forth should be directed to the Groundwater Branch,UST
Compliance Unit at(334)270-5655.
Type of Test Performed-check all that apply: utornatic Line Leak Detector(ALLD) ne Tightness Test
Reason for Test-check all that apply: nual Test ONew Installation ORequlred by ADEM Enforcement Action
Manufacturer of ALLD Test Equiptiera:VMl I Model or Version:LDT890
Manufacturer of Line Tightness Test Equipment Estsbrooks Ezy Chalk Model or Version:Manual Test
ADEM Unique Tank#
Product Stored
berglass rglaes Ofiberglass Ofiberglass Ofiberglass Ofiberglass
Piping material Ofiemble 06ezible Oaexible Oflexible Ofiexlbie Oeemble
Osteel Defeat Dsteel Oates] Osteel Osteel
Approx.length of piping v /_�,, i
run tested nearest foot C00
Piping capacity
(gallons)
Autornatit Line Leak Detector Test
Type of ALLD echanicel echanicai Omechanical Omechanical Omechamical Omechaniwl
Oelectronic Delectronic Oelectronic Oeleclronic Delectionic Deleclronic
Line pressure O /D
during ALLD test(psi)
Measured ALLD leak rete 2
(gph)
P
Ofail ass Ofail [pass Ofall Opals O fail Opass [hail Opals [fail
Results of ALLD test
OPaw luslve [inconclu6(ve Olnconcluslve Olnconclusivs [inconclusive Oinconeiusive
Line Tightness Teat
Dre pressure 50 cludiren line test i
Measured line leak rate D O
(gph)
Results of line ,30m Dfail Ofail Draw [fail Dpass Ofall Dpass Dfail Dpass OfaiI
tl htness teat Dinconclusive [inowwimive Dincondusive OInconclusive Dinconclusive [03=Oleelve,
Repairs Needed Data of Repair Description of any Repairs
Tester's Signature:
ADEM Form,cox(new form)
Quality
Cathodic,Tank&Line Testing
PO Box 1457
NonhpDM AL 35476
Pb: (205)339-3535
DATE: lZ - Z3 -Zo
ESTABROOK'S E?Y CHEK TEST SITE: Un kd fr%A a fLWA
ADDRESS: II I'•
PRODUCT LINE TESTER o8
TEST RESULTS TESTER NAME: Christopher(Hod )Dempsey
CERTIFICATION Y: AL 69-0691
APPLIED PRESSURE: 50 PSI
PRODUCT TYPE OR TANK M 13 8 MODUCTTYPEORTANKM
TIME DATA -/+ GPL RES GPM TIME DATA /+ GPL RES GPM
90 O .0037 Q p $:YO sy d .0037 D
O .0037 0 �_ Q .0037 O O
�Q .0037 �_ d :/D .0037 �-
.0037 .0037
- .0037 .0037 -
- 0037 .0037
Final Result: za Firal Result:
PRODUa TYPE OR TANK M PROCKja TYPE OR TANK R:
TIME DATA -/+ GPL RES GPM TIME DATA -/+ GPL RES GPM
_ .0037 .0037 _
.0037 .0037
.0037 .0037 -
.0037 .0037 -
_ .0037 .0037 -_
.0037 .0037
Final Result: Final Result:
PRODUa TYPE OR TANK Ih. PRODULTTYPEORTANKR:
TIME DATA -/+ GPL RES GPM TIME DATA -/+ GPL RES GPM
_ .0037 .0037
_ .0037 .0037 -
_ .0037 .0037 -_
_ .0037 .0037
_ .0037 .0037 _
.0037 .0037
Final Result: Final Result:
Quality
Cathodic, Tank& Line Testing
PO Box 1457
Nsnhpsn,AL 35476
Ph: (205)339-3535 1
DATE: I7 -2,3 20
VMI LDT 890 TEST SITE: 3
LEAK DETECTOR ADDRESS:
TEST RESULTS
TESTER NAME: Christo h.r Demosev
CERTIFICATION#: 69-0691
TEST REPORT INDICATES
TYPE OF LEAK DETECTOR TESTED
PUMP# AKE MODEL SERIAL#
1 � FX2v
2
3
4
5
6
7
8
FUNCTIONAL TEST LEAK
PRODUCT METERING ELEMENT RATE OPENING PASS
PUMP# TYPE PRESSURE HOLDING PSI RESILIENCY MUMIN TIME FAIL
1 t G / 0 189 m1 Sc
2 26 17Z 189 m1 3 J
3 189 ml
4 199.1
S 189 ml
6 189 ml
7 189 ml
9 189 ml