ST8401-CS 861024GINN, INC.
CONSULTING ENGINEERS
UTILITY LINE
INSPECTION AND TESTING
Date: ./OP- 2~-~ Area: Line:
Diameter: ~" ~
Length: ~ ~ Plan Sheet No:
PRESSURE TEST
START F I N I SH
Time: -----~o~ ~,/~f. Time: /~'~o~.~f.
Pressure: ./.5'~' ,~. ~..~. Pressure: /d-~ ,e/.~. Z_
Allowable Leakage Per Day.:.
(Il.kS gpd) X G~Z miles of pipe) X (~26/ inch Diameter) =
Gallons Lost Per Day:
(,' Z/ Gal. Lost) ? ( 2 Hrs. Tested) X 24 Hrs.
Passed:
INF I LTRAT ION/EXF I LTRAT ION TEST
START FINISH
Time: Time:
Allowable Leakage Per Day:
(250 gpd)- X ( miles of pipe) X (
inch Diameter)
Gallons Lost Per Day:
( Gal. Lost) ? (
Passed:
COMMENTS:
Hrs. Tested) X 24 Hrs. =
Rejected
13T$0 Midway Road ·