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Specimen Label:<br />

Date:<br />

Ullage: inehes<br />

Height of Polymer Matrix: inches<br />

ist Hole<br />

2nd Hole<br />

3rd Hole<br />

4th Hole<br />

5th Hole<br />

6th Hole<br />

Bottom Hole<br />

Total Free Liquid Collected<br />

Record additional observations on reserve<br />

WHC-SD-W100-TI-003 Rev. 0<br />

PRESENCE OF FREE LIQUID<br />

DATA SHEET<br />

Liauid Volume (mis)<br />

Technician<br />

Technician<br />

Engineering<br />

Stock Eauioment Comoam, C-42<br />

PROCEDURr 90ll0-0<br />

Date<br />

Date<br />

Date<br />

Pace -2L of 37<br />

;

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