Laserfiche WebLink
RECEIVED M ■ r <br /> San Joaquin Valley OCT 222018 HEALTHY AIR LIVING' <br /> www.healthyairliving.com <br /> AIR POLLUTION CONTROL DISTRICT ENVIRONMENTAL HEALTH Make one change for clean air! <br /> TP-201.6C or EVR Liquid�ep�aMTest <br /> Liquid Removal Rate Report Form <br /> Permit Number:N-714 Test Company:AFFORDA-TEST <br /> Site Name:FLAG CITY CHEVRON Technician:ZANE NIMMO <br /> Site Address:6421 CAPITOL AVENUE Certification Number: 0083 Expiration Date: 2020 <br /> City:LODI, CA Zip:95240 District: SJVAPCD <br /> Date/Time of Test:9/26/2018 VST(if applicable):3000839502 2/15/2020 <br /> TEST INFORMATION <br /> Phase II vapor recovery system executive order: ❑ G-70-52(Pre-Phase 1I EVR balance for AST&UST) ® VR-203/204(VST Phase II EVR balance) <br /> EVR Short VI G T VF Wi Wr VW Version V Dispensing VI— W—VF <br /> Nozzle Fuel ** Rate G <br /> Number Grade Volume of Gas added to hose Gallons Time to Gx 60 Gas drained Gas introduced Gas Liquid removal Pass/Fail <br /> Gas drained (150—175 ml) dispensed dispense T after after dispensing recovered Wr-Wz rate removal <br /> from hose nd sec. dispensing 150—175 ml <br /> I ALL 0 Pass <br /> 2 ALL 0 Pass <br /> 3 ALL 0 Pass <br /> 4 ALL 0 Pass <br /> 5 ALL 0 Pass <br /> 6 ALL 0 Pass <br /> 7 ALL 0 Pass <br /> 8 ALL 0 Pass <br /> 9 ALL 0 Pass <br /> 10 ALL 0 Pass <br /> I1 ALL 0 Pass <br /> 12 ALL 0 Pass <br /> — <br /> I declare, under penalty ofperjury under the laws of the state of California that based on information and beliefformed after reasonable inquiry,the statements and <br /> information provided in this document are true, accurate, and complete. <br /> Signature of Technician: O "' Date: 912612018 <br /> **NOTE: For EVR systems—Prior to the Leak Decay Test,if the liquid drained from the hose is<25 ml,record the amount in the EVR short version column,mark the <br /> test as pass,and no further testing is required. <br /> \cr. 1.5—08.)u.14 <br />