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^fork Order: 2273688 <br /> (ESV 're5111181'0,1.YewRw I-1IWI01M <br /> Emergency Shut Off (ESO) <br /> Dispenser Emergency Shutoff Valy (ESV) <br /> ANNUAL TEST RECORD LOCATIONS AND TE T DATA <br /> Testing 1 TANKNOI,OGY Date: ^�L ---�----t <br /> company; _ 17413160 <br /> acatlon Name: <br /> L �- Store N= j3 StMe to k: <br /> I 535E clty: state:Aaare9._ s <br /> Ewer encu Shut Off(ESO Testin Results <br /> Onoy 3=L m accordance with"ESO Vendor Fetter(3-21-05).doe', fn om Retail Cou'RHanee <br /> Department,as a part of annual compliance testing,This representative tested the Emergency Shut Off <br /> an <br /> SO)switches indicated on this sketch.Fijidinpp listed below: <br /> Emergency Shat OtF(ESO) If No,Provide D Cnlled <br /> Oparntionel? .Y N Maintenance Log N c --3 <br /> �� <br /> Di s eraser Emex enc Shutoff Valve ESV Testin R sults <br /> On in accordance with NFPA 30A this representative tested the automatic-closing feature <br /> of the Dispenser Emergency Shutoff VALVE(S)(ESV)located in the suppl lines at the base of each <br /> individual island type dispenser indicated on the diagram below-Each devi (#) <br /> in a11, <br /> would automaticail close.Findin listed below: 1 <br /> Disp.Fjnergancy Slee(D:1 ff 40,Provide D Called <br /> Val vc(ESV?operational? ( YIN Maintenance Log# <br /> viae l'eseaa: t <br /> L <br /> Sim ap CLo-lux n6 f <br /> fOncrn q ¢ `>u $y� p A$ 45 <br /> .� u "� i�d tl <br /> WAS N�tttl Iao,,e x. -2 <br /> �-p�Qo�`F,w $ <br /> Ts yA , Q;re -so* <br /> Ai6l <br /> rc r-z <br /> S�aAs6 oiF1� B.y F�.1tiry ®p-Ti <br /> Si ature O Re resentative: <br /> Tanknology Inc. 11000 N.MoPac Expwy#500,Austin,Texas 78759 <br />