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AFFO"A TEST E.O.VR-202 Veeder-Root In-Station Diagnostics Va or Flow Meter Operability Test Report Form Permit Number: N388-1-7 #17-24110 Test Company: AFFORDA TEST Site Name: Pacific Service Station Technician: FELIX R. RAMIREZ Site Address: 6131 PACIFIC AVE Certification.Number Expiratiori'Date City: STOCKTON CALIFORNIA Zip:95207 District: 0099 2018 Date/Time of Test:08-31-17 Veeder-Root:B34976 2018 VAPOR FLOW METEIVOPERABIUTTTEST 3; Vapor flow meter serial number 17470 57700 Dispenser fueling point numbers FP: 1 FP: 3 Low grade V/L result #11 1.00 1.00 ISD A/L value #1 1.07 1.03 Difference between V/L result #1 and A/L value #1 (V/L-A/L) .07 .03 Pass / Fail (Pass= difference within±0.15), if fail continue PASS PASS Low grade V/L result #2 Low grade V/L result #3 Average of 3 V/L results ISD A/L value #2 ISD A/L value #3 Average of 3 ISD A/L results Difference between Average V/L and Average A/L values (Average V/L- Average A/L Pass / Fail (Pass= difference within±0.15) If fail, repeat steps for the second fueling point on the dispenser E - Vapor flow meter serial number a 17468 61370 Dispenser fueling point numbers FP: 5 FP: 7 Low grade V/L result #1 1.00 1.00 ISD A/L value #1 1.09 1.02 Difference between V/L result #1 and A/L value #1 V/L—A/L .09 .02 Pass/Fail Pass=difference within±0.15 , if fail continue PASS PASS Low grade V/L result #2 Low grade V/L result #3 Average of 3 V/L results ISD A/L value #2 ISD A/L value #3 Average of 3 ISD A/L results Difference between Average V/L and Average A/L values(Average V/L—Average A/L) Pass/ Fail Pass = difference within±0.15 If fail, repeat steps for the second fueling point on the dispenser 1 declare, under penalty of perjury under the laws of the state of California that based on information and belief formed after reasonable inquiry, the statements and information provided in the document are true, accurate, and complete. Signature of Technician: Date: 8-31-17 Ver. 1.0—12 26.07