ATG-RP 1200_2019

Fascility Name :

Citgo

Address :

1356 Portage Ave

City, State, Zip Code:

South Bend, Indiana, 46616

Fascility Id :

1634

Testing Company:

Midwest Tank Testing

Owner:

HN Food Plus Inc.

Address :

City, State, Zip Code:

, , 46616

Phone :

(574) 329-8041

Phone :

(000) 000-0000

Date :

Tank Number	Tank 1	Tank 2	Tank 3
Product Stored
ATG Brand and Model
1. Tank Volume, gallons
2. Tank Diameter, inches
3. After removing the ATG from the tank, it has been inspected and any damaged or missing parts replaced?
4. Float moves freely on the stem without binding?	Yes No	Yes No	Yes No
5. Fuel float level agrees with the value programmed into the console?	Yes No	Yes No	Yes No
6. Water float level agrees with the value pro- grammed into the console?	Yes No	Yes No	Yes No
7. Inch level from bottom of stem when 90% alarm is triggered.
8. Inch level at which the overfill alarm activates corresponds with value programmed in the gauge?	Yes No	Yes No	Yes No
9. Inch level from the bottom when the water float first triggers an alarm.
10. Inch level at which the water float alarm acti-vates corresponds with value programmed in the gauge?	Yes No	Yes No	Yes No
Test Results	Pass Fail	Pass Fail	Pass Fail

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