CUSTOMER/LOCATION: ____________________________________________________________ FILE NO.: ____________
DATE: __________________________________________ TESTED BY: __________________________________________
FOAM CONCENTRATE TYPE / LOT NO.:______________________________________________________________________
M
ETER TYPE:________ CONDUCTIVITY:________ REFRACTOMETER MODEL: __________________________________
PERCENT FOAM SOLUTION
METER READING
CALIBRATION STANDARDS METER READING
FOAM CONCENTRATE
WATER
PRE-MIX #1 —
PRE-MIX #2 —
PRE-MIX #3 —
SYSTEM DISCHARGE SAMPLE METER READING PERCENT FOAM SOLUTION
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