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San Joaquion Valley <br /> HEALTHY AIR LIVING' <br /> AIR DIST <br /> www,healthy airlivintg <br /> .co <br /> an <br /> POLLUTION CONTROL DIS 1 RIC 1 14ake one change for clean aIt'! <br /> E.O. VR-201/202 <br /> Healy Dispenser Vapor Line Integrity Test Report Form <br /> Permit Number: Test Company:TANKNOLOGY INC. <br /> Site Name:7-ELEVEN 432190,MKT 2368 Technician:Ryan Casey <br /> Site Address:4943 S.KINGSLEY(FRONTAGE RD)HWY 99 a ARCH AIRPORT RD wCertification Number Expiration Date <br /> City:STOCKTON Zip:95206 District: <br /> Date/Time of Test:3/19/2015 Frankiin(Healy):4459713702 2/20/2017 <br /> DISPENSER'VAPOR LINE INTEGRITY TEST <br /> Initial Vacuum After Pass/Fail <br /> Dispenser tic Closing the Ball Valve Irinai Vacuum After 60 <br /> seconds(in.1120) (vacuum reading cannot fall <br /> (in.H2O) mere than 4 in.I2O) <br /> 112 __._..Y� <br /> 77.00 <br /> 76.00 Pass <br /> 3/4 79.00 76.00 Pass5/6 --� <br /> 74.00 74.00 <br /> Pass <br /> 718 76.00 75.00 Pass <br /> 9/10 79.00 78.00 Pass <br /> 11112 _ <br /> 78.00 78.00 Pass <br /> I declare, under penalty ofperjury under the laws of the state of California that based on information and beliefformed after reasonable inyuily, the <br /> statements and information provided in this document are true,accurate,and complete. <br /> Signature of Technician: . Bate:3/19/2015 <br /> WO:2321928 <br /> REGEIV E L <br /> MAY 0 4 2015 <br /> ENVIRONMENTX <br /> X FXTY r)cOAD-RAr- <br />