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fforda—Te t 416 2°"Street Phone: (209)744-0112 <br /> Galt,Ca 95632 Fax: (209)744-0116 <br /> affords softeom.net <br /> E.O.VR-201/202 <br /> Vapor-to-Liquid(V/Q Volume Ratio Test Report Form <br /> Permit Number:N-388-1-7 CONF# 18-25794 Test company:AFFORDA-TE$T <br /> Site Name:PACIFIC SERVICE STATION Technician: ZANE NIMMO <br /> Site Address:6131 PACIFIC AVENUE Certification Number Expiration Date <br /> city: STOCKTON zip:95207 District:SJVAPCD <br /> DoteRme of Test:8/28/2018 Franklin Healy):1009843708 1/8/2019 <br /> TEST INFORMATION <br /> Gas volume meter type i.e., Roots meter or Tri-Tester) TRI TESTER <br /> Gas volume meter serial or identification number: 914644 <br /> Tri-Tester software version,if applicable must be version 2.01) 2.96/2.01/DR <br /> Calibration date for Gas volume meter(must be within 180 days of the test) 8/13/2018 <br /> Gas volume meter correction factor,y(Roots meter) 1,004 <br /> Pre-test leak check for Roots meter: Initial pressure: 30 sec.pressure: Pre-test leak check for Tri-tester:FLAT Re-inflate in 30 sec.❑Yes M No <br /> Post-test leak check for Roots meter: Initial pressure: 30 sec.pressure: Post-test leak check for Tri-tester:FLAT Re-inflate in 30 sec.❑Yes M No <br /> Initial Final Total Gas Initial Meter Final Meter <br /> Noale Fuel Noule Model&Serial Dispenser Dispenser Time Dispensing Pass/Fail <br /> Number Grade No. Rea ding Reading Dispensed Reading(ft3), Reading V/L <br /> 9 g (gal.) [sec) Rate(gal.) V1 (ft3),Vi (P/F) <br /> al.,G� - al.,G <br /> 1 87 HEALY 900 0.000 2.000 2.000 7.98 1.04 PASS <br /> 89 7.38 1.04 PASS <br /> 91 6.79 1.05 PASS <br /> 2 87 8.32 1.11 PASS <br /> 89 7.31 1.04 PASS <br /> 91 6.67 1.02 PASS <br /> I 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 <br /> provided in the document are true, accurate,and complete. <br /> Signature of Technician: Date: 812812018 <br /> Ver. 1.0- 12.26.07 <br />