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Work Order: 2263813 <br /> (ESO)&(ESV)Testing F -Version 1-9/4/2009 <br /> Emergency Shut Off I ) <br /> Dispenser me e y Shutoff Valve (ESV, ) <br /> ANNUAL TEST RECORD LOCATIONS AND TEST DAT <br /> Testing TANKNOLOGY G`d <br /> Company: Date: <br /> Location Name: e V ro o Store#: CjE` O State #: <br /> `�` C <br /> Address: u („f q-�CI® R City: �� State: <br /> EmeMengy ShutU SU Testinj Results <br /> On2--ZQ-V1 in accordance with"FSO Vend r Letter(3-21-05).doc", from Retail!Compliance <br /> Department,as a part of annual compliance testis ,this representative tested the Emer�ency Shut Off <br /> S® switches indicated on this sketch.Findings listed below: <br /> Emergency Shut Off(ESO) If No,Provide <br /> Operational? Maintenance Log# Date Called <br /> Dispenser Emergengy Shutoff Vale ESV Testing Results <br /> On in accordance with NEPA 30A t tis representative tested the automatic-closing feature <br /> of the Dispenser Emergency Shutoff VALVE(S) ESV)located in the supply lines at the base of each <br /> individual island type dispenser indicated on the liagram below.Each device(#) in all, <br /> would automatically close.Findings listed below <br /> Disp.Emergency Shut OffIf No,Provide <br /> Valve(ESV)Operational? Maintenance Log# Date Called <br /> Site Map Of Location and Placement of Ikviees Tested- <br /> \j e <br /> C 75EJ <br /> SO <br /> TA� <br /> SO k5 <br /> -S-EQre- <br /> S' nature Of Re res ive: <br /> Tanknology Inc. 8501 N.MoPac Expressway,Suite 400,Austin,Texas 78759 <br />