Document rxqnoO4dxee7Znmgbe6Lk9jd0
GENERAL OFFICES
FIELD INSPECTION REPORT
FIELD 5ERVCE OFFICES
MEASl'3: = qom .TATlON NAM: LOCATION ______
4/7. U/r,
/Up UaAs__
MEASURETO DAT =
METER: ORIFIgg - FLOW COMP
MAKE
>TOV
C
RANGE
OTHER OIFF.
TYPE
VERCURY
CLOCK
SE_R_ No^ 01F F ZERO
,-2-4-'KN'- 43 h
/73
[ FOUND' f~)
WOR K-P--
,pO
F OX 3030
ROCKWELL
STATIC
1
01A PH RAM
TRANSDUCER
[ OTHER 1 .
[ MODEL 1
l
LEFT
]
3? -7,
ATMOS. ] "
INSTALL REMOVE
FOUND COND'T
TUBE FITTING COND'T
//&
ORIFICE CHANGE
[
size
1
\ TIME
)
[
SIZE
]
r
TIME
]_
ORIFICE INSPECTION
[
SIZE
1
INSP 1
v^kT)
GOOD
FAIR
POOR *
Asj;;:r*
[ BORE ]
SIMPLEX FAIR
JUNIOR POOH*
SENIOR reject-
PEN LEAKS
[ DlFF. ARC ] [ FOUND ]
FRICTION l
FOUND )
OKfFtESEJ> yes'/no.
TIME LAG ]
LEFT
]
O^-RESET/ YES^-Wo)
AMOUNT ]____________________
DIFFERENTIAL
FOUND 0<^)
RE-SET
R EC A LI 3
~"r
';^L
down
v.c
MET ]]
'.NO
MET
/FOuNDOp lA'Tli'. D'.V
PRESSURE PE-SET
'EST VST
D'.V
RECALI8. FINAL MET
GAS SPECIFIC GRAVITY _
METHOD GAS LIQ
RANAREX
OTHp:
GRAV1TOMETEFI/DENS1TOMETER
. range
(testgr.]
found
[left]
ADJUST
[ RESET ]
YES* NO
RE CA.I3.]
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7^\
ii i.
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CnART SCALE SCANNER
LINEAR f Z</r7}
`UM YES
C3>
/'"no'")
TYPE
THERMOMETER INDICATE
DIAL
7stTcT)
MAKE
AMERICAN
roxBono
[ OT-ER
TRANSMITTER
( type ]____________ FOUND OK _____________
RECEIVER
[ type ] FOUND OK
GAS TURBO METER TEST
. [ OUT-PUT ] SCALE ]
KE. DECAY TIME [ TEST ] type INSTRUMENT ______ INSTRUMENT [ TEST ]
MOLLY: UNITS _
OUTPUT READING GEAR COM8
HlGH-LC/ [ FOUND
DEW PT. TEMP.
DEW POINT DETERMINATION IhYD cars.
.SIZE
L35.WAT.'MMCF .
TEST ADJUST
TEMP. RE-SET
.[ RECORD ] _______________
TYPE DEHYDRATOR_____
) YES* NO
[ RE-CALIB ] YES* NO
SAMPLE POINT [ TEMP. ]
5R E3. ]
PROCUREMENT OF SAMPLES FOR ANALYSIS
SAMPLE CYl. NO.
REMARKS EXPLAIN
V
j\,rr
; SAM RLE GAS/DIST/OIL/Y/ATER
deft
s/.t/Yt/i
SOURCE SAMPLE TEMP.
/)/ //777 7
FSIG
WITNESS Signature
CRM F-10 I Rev
CUH 000009103
SAMPLE CYL. NO.
REMARKS'
iSAMPLE GAS/DIST/OIL/WATER
SOURCE SAMPLE TEMP.
PSIG
CWH 000009.104