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OIL EQUIPMENTSERVICE <br />Division of Keith A. Tallia, Inc. <br />Customer <br />Norms 76 <br />Location <br />633 E. Victor Rd., Lodi, CA 95240 <br />"Technician <br />James P. Hesketh <br />STATE LICENSE No. 323417 <br />CLASSIFICATION: A -RAZ., C61 D40 <br />STATE ENVIRONMENTAL ASSESSOR No. 01781 <br />Product <br />Plus <br />Telephone: (209) 754-1808 <br />Fax: (209) 754-5726 <br />Post Office Box 950 <br />750 Industrial Way <br />SAN ANDREAS, CALIFORNIA 95249 <br />Submersible Pump Identification <br />Manufactures Model No. Serial Number <br />Tokheim 585-34 585-2284_ <br />Leak Detector Identification <br />Manufacturer Descri tp i0 Ether Stvle teak Daceto; <br />Red Jacket Diaphragm-type- <br />116-056 <br />iaphragm-type116-056 Piston -type X <br />Tamper -proof seal installed? Yes No X <br />Leak Detector in Submersible Pump <br />Test at Dispenser <br />1. Operating Pump Pressure 2 7 psi (para. 15) <br />2. Gallons per hour rate 3 (para. 22) <br />3. Line pressure with pump shut off 2 5 psi (para. 23) <br />4. Bleedback Test with pump off 350 ml (para. 26) <br />5. Step -through time to full flow__ $____seconds (para. 30) <br />6. Leak detector stays in leak search position. (para. 42) Yes X <br />No <br />LEAK DETECTOR TEST *Complete thermal expansion test <br />Note: Pass Leak detector tits test protocol before failing leak detector. <br />Fail = Leak detector fails test protocol <br />Pass X <br />Fail___._ <br />rcnnici.an <br />ames P. Hesketh <br />