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Facility Name: Costco # 1031 Manteca (Page 4) I. Results of Vacuum/Pressure Monitoring Equipment Testing urer: Veeder-Root Model: 332117.001 System Type: ❑ Pressure ❑Vacuum F A Component(s) Monitored by this Sensor: 87a Product Line Sensor Functionality Test Results: ❑ Pass; ❑ Fail Interstitial Communication Test Result: ❑ Pass: ❑ Fail si 0 Component(s) Monitored by this Sensor: 87a Vapor Line Sensor Functionality Test Results: 0 Pass; ❑ Fail interstitial Communication Test Result: ® Pass: ❑ Fail s1 1 Component(s) Monitored by this Sensor: 87a Vent Line Sensor Functionality Test Results: S Pass; ❑ Fail Interstitial Communication Test Result: Pass: ❑ Fail s12 Component(s) Monitored by this Sensor: 87b Product Line Sensor Functionality Test Results: ® Pass; ❑ Fail Interstitial Communication Test Result ❑ Pass: ❑ Fail s13 Component(s) Monitored by this Sensor: 87b Syphon Line Sensor Functionality Test Results: ❑ Pass; ❑ Fail Interstitial Communication Test Result: ❑ Pass: ❑ Fail E4 Component(s) Monitored by this Sensor: 87b Vent Line Sensor Functionality Test Results: ® Pass; ❑ Fail Interstitial Communication Test Result: Pass: ❑ Fail s17 Component(s) Monitored by this Sensor: 91 Product Line Sensor Functionality Test Results: ® Pass; ElFail interstitial Communication Test Result: ❑ Pass: ❑ Fail S18 Component(s) Monitored by this Sensor: 91 Vent Line Sensor Functionality Test Results: ® Pass; ❑ Fail Interstitial Communication Test Result: ® Pass: ❑ Fail How was interstitial communication verified? ❑ Leak Introduced at Far End of Interstitial Space; ❑ Gauge; ❑ Visual Inspection; Other (Describe in ! below) Vacuum was restored to operating levels in all interstitial spaces: Z Yes ❑ No (If no, describe in J below) J. Comments: