ATG-RP 1200_2019

Fascility Name :

Corner Food Mart

Address :

541 W Walnut Street

City, State, Zip Code:

North Vernon, Indiana, 47265

Fascility Id :

24287

Testing Company:

TANKS DATA LLC

Owner:

JLG 4 Food Mart LLC

Address :

City, State, Zip Code:

, , 47201

Phone :

765-481-7475

Phone :

Date :

Tank Number	Tank 1	Tank 2	Tank 3	Tank 4
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	Yes No
5. Fuel float level agrees with the value programmed into the console?	Yes No	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	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	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	Yes No
Test Results	Pass Fail	Pass Fail	Pass Fail	Pass Fail

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