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San Joaquin Valley <br />AIR POLLUTION CONTROL DISTRICT <br />E.O. VR -201/202 <br />Vapor -to -Liquid (VAL) Volume Ratio Test Report Form <br />Permit Number: N-5020-1-2 <br />Test Company: Service Statioa Systems <br />Site Name: Safeway <br />Technician; Bryan Lundien <br />Site Address: 6425 N. Pacific Ave. <br />;<c L _ <br />iratida -s'� <br />,,, - p <br />� 4,• <br />City: Stockton <br />Zip: 95207 <br />District: SN -0064 <br />2/14/10 <br />Daterrime of Test: 12t16/08 C 8:30am <br />Franklin (Healy): 35377973761 <br />I/8/10 <br />A`i�a <br />J, <br />1 <br />Gas volume meter type (i.e., Roots meter in Tri -Tester) <br />Tri -Tester <br />Gas volume meter serial or identification number: <br />0736477 <br />Tri -rester software version, if applicable (must be version 2.01) <br />2.01 <br />Calibration date for Gas volume meter (must be within 180 days of the test) <br />7/21/08 <br />Gas volume meter correction factor, y (Roots meter) <br />Pre-test leak check far Roots meter: Initial pressure: <br />30 sec. pressure: <br />Pre-test leak check for Tri -tester: <br />Re -inflate in 30 sec. ❑ Yes ® No <br />Post-test leak check for Roots meter: Initial pressure: <br />30 sec. pressure: <br />Post-test leak check for Tri -tester: <br />Re -inflate in 30 sec. ❑Yes ®No <br />C 'Initial <br />' Dis ns <br />Ai ,zte )'vel Nozzle Modcf& Serial : -. ,� <br />,.,,ym t ({rade NO'L . er <br />�. <br />d <br />k4nar fiorat Gas <br />; Dispenser <br />1)3spensed <br />'Reading , <br />(gal ), Gr t(al > <br />r <br />Trme Disper�m ' ]nuial Meter <br />keadin�(f[), <br />< c) }iato-(6ab' � - c <br />V. <br />Final Meter <br />Reading ,V/L <br />) <br />(ft ), Vr <br />r <br />Pas <br />( n <br />; <br />1 87 Healy 901/, M64 08-6403 <br />8.061.06 <br />1.06 <br />Pass <br />1 89 Healy 900, M6(106-6403 <br />8.06 <br />1.05 <br />Pass <br />1 91 Heal 900, 46008-6403 <br />8.15 <br />1.07 <br />Pass <br />2 87 Heal 900, 43008-0767 <br />8.06 <br />1.06 <br />Pass <br />2 89 Healy 9W, 43(1011-0767 <br />9.15 <br />1.07 <br />Pass <br />2 91 Heal 900, 43008-0767 <br />8.06 <br />1.08 <br />Pass <br />3 87 Heal 90(1, 43006-0767 <br />7.65 <br />1.05 <br />Pass <br />3 89 Healy 9W, M3008-0767 <br />8.15 <br />1.01 <br />Pass <br />I declare, under penalty of perjury under the laws of the state of Califonda that based on information and betief funned after reasonable inquire, the <br />statements and information provided in this document are true, accurate, and complete. <br />Signature of Technician: / Date: 12/16/08 <br />