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Tanknology Impact Valve �= <br /> Inspection <br /> MAS 0 4 2015 <br /> Impact Valve Operational <br /> Inspection ENVIRONMENTA <br /> Work Order: 2322332 Date: 2/27/2015 <br /> Site Name/ID: TRACY PETRO <br /> Address: 3400 N. MACARTHUR DR <br /> City: TRACY State: CA Zip: 95376 <br /> Dispenser Secure Valve <br /> Number Grade Mount? Lock? Pass/ Fail Comments <br /> 1/2 40 r r • Pass!" Fail C Not Tested <br /> 1/2 87 r r • Pass(- Fail f Not Tested <br /> 1/2 91 W • Pass f Fail C Not Tested <br /> 3/4 40 r rv-,. • Pass f Fail r Not Tested <br /> 3/4 87 F. W + Pass r Fail r Not Tested <br /> 3/4 91 Frv- • Pass r Fail r Not Tested <br /> 5/6 40 r ry-1 • Pass r Fail r Not Tested <br /> 5/6 87 r ry-1 • Pass r Fail C Not Tested <br /> 5/6 91 r w • Pass C Fail C Not Tested <br /> 7/8 40 V r IT Pass(- Fail C Not Tested <br /> 7/8 87 W W • Pass C Fail C Not Tested <br /> 7/8 91 R' FV- r Pass r Fail r Not Tested <br /> Technician Comments: <br /> Technician Name: Jarrod <br /> l,aCooke <br /> Signature: <br /> Environmental Compliance for Petroleum Systems <br /> 02015 Tanknology Inc.,Austin,TX.All rights reserved. tanknology.com <br />