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TO BE ENACTED <br /> APPENDIX C <br /> STAGE II POST TEST INSPECTION FORM <br /> Facility Name: Application# <br /> 19976 <br /> Address: County: <br /> 1399 N.MAIN ST. <br /> City,State,Zip <br /> MANTECA, CA 95336 <br /> DISPENSER AREA INSPECTION <br /> [ ] All Vapor pipes under the dispenser are capped, plugged, or re-attached. <br /> [ ] No leaks are present under dispenser, nor from hoses or nozzles. <br /> [ ] All impact valves are open on all product lines. <br /> [ ] All dispenser panels are correctly re-installed. <br /> [ ] All lock-outs or"Out of Service" bags are removed from dispenser nozzles. <br /> [ ] All tools, testing equipment, cones, and caution tape removed from dispenser area. <br /> TANK AREA INSPECTION <br /> [ ] Isolation plugs are removed from vapor risers (if applicable). <br /> [ ] All tank top components (plugs, caps, etc...) are reinstalled and secure. <br /> [ ] "Drop out tank" free of product and functioning properly (with all caps replaced). <br /> [ ] Submersible pit(s)free from leaks. <br /> [ ] All tools, testing equipment, cones, and caution tape removed from tank area. <br /> [ ] All lids and covers are properly replaced. <br /> Site Mgr.NAME: Site Mgr.Signature: Date: <br /> Tester NAME: Testers Signature: Date: <br /> ANEIL CHAND 08/28/200 <br /> Testing Company and Address: <br /> TANKNOLOGY, 8900 SHOAL CREEK, SUITE 200, AUSTIN,TX 78757 <br />