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.. Fdrm 3.1 Notice of Totalizing Flow Meter Re -Verification, Installation or Replacement <br />Manufacturer &,,,, ` 2 d /*, Model No&? o <br />Northing: V,, <br />Page 2 of 6 <br />r <br />Beginning Remote Reading: Time: Ending Remote Reading: Time: <br />Do these readings match the installed TFM readings? OYes 0 No If no, explain: <br />Meter Type�� i7l <br />r Size Multiplier No. of recording digits <br />p t7I(X, oa/ 1 6 <br />F] Gallons ®Acre Feet ❑ Cubic Feet p Other, describe: <br />Vertical I , 2 S v <br />/off/y..? ) I/D 50 I ip75 <br />Date of Test: Time of Test (Begin): Length of time pump has been � G -t <br />9 i 3 running prior to Tester's arrival: (HH:MM) <br />Collins Meter <br />GPM Factor. 411A Stop Clamp Settings: <br />�n�isi! X80 is/= c7' <br />y- <br />'7T- <br />0 <br />7rD . ot. K <br />3 3.3l __11 5,'3.3/ %a r /S, 5G a7/ya,S <br />gZc�. �z Gdll0w 50 goof <br />ExistingK-factor /Li � <br />Adjusted K -factor_ <br />Flow rate with Collins tube removed: <br />(Show Q to the nearest 0.00 GPM) Avg QT: < o O (Show Q to the nearest 0.00 GPM) Avg QI: <br />Correction _ AVG QT �a0 3 G <br />_ Calibration Coefficient must be <br />Factor shown to the nearest 0.000 <br />AVG QI <br />Colorado Division of Water Resources www.water.state.co.us Effective 05/01/2014 <br />