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1X0t D #0 ,4UST CV5, *OIX Aka WR ORy[IOGKL• TP-201 . 101) Leak Rate of Drop Tube/Drain Valve Assembly and Leak Rate of Drop Tube Overfill Protection Devices and Spill Container Drain Valves Report Form Permit Number: Test Company : Confidence UST Services, Inc. Confirmation : Technician : Alan Johnson Site Name : Stockton Gas Certification Number Expiration Date Site Address : 1687 Highway 99 District: SJV-0267 9/30/2019 City/Zip: Stockton 95202 Franklin (Healy) : 1001973708 04/08/2021 Date/Time of Test : 5/10/2019 at Veeder-Root: B45536 06/21 /2019 DROP TUBE DRAIN VALVE AND OVERFILL PROTECTION DEVICE PRESSURE INTEGRITY TEST ❑ Straight Drop Tube ' 0 Drop Tube with an Overfill Protection Device' Pressure measuring device 0 digital manometer ❑ mechanical gauge Calibration date for pressure measuring device must be within 180 days of the test) 03/20/2019 Ending value dor digital manometer drift test if applicable (must be 0. 01 in. w. c. or less) 0 . 00" Drop Tube Drain Valve Pressure Test: Drop Tube Overfill Device Pressure Test " Corrected " Overfill Device Leak Rate Flow rate 80 ml/min Flow rate 200 mUmin Minus Equals Time to reach 2 in. Drain valve Final Time to reach 2 in. Overfill Final Overfill Device Drain Valve Corrected w. c. at 80 ml/min. leak rate' Pressure w. c. at 200 ml/min. leak rate' pressure Leak Rate Leak Rate Leak Rate Tank Grade sec, ml/min in, w. c , mins , ml/min. in. w. c. ml/min. ml/min. ml/min. 1 Regular 2 min 4 see 11 ml 2. 04" 2 Super 2 min 23 see 10 ml 2009" 3 4 NOTES : 'A straight drop tube must be tested with a bladder in place and using a flow rate of 80 ml/min. ZThe bladder section of TP-201 . 11) may be skipped if the entire drop tube passes with a leak rate below 80 ml/min. z 'Leak Rate = nitrogen flow rate needed to maintain a constant pressure (at least 2 in. w.c.) for 30 seconds. 00 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 Cil Z statements and information provided in this document are true, accurate, and complete. > —q 2: Signature of Technician : Date : 5/10/2019 = a M o °