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Work Order: 1184768 <br />(ESO) & (ESV) Testing Form - version 1- 6/25!2007 <br />Emergency Shut Off (ESO) & <br />Dispenser Emergency Shutoff Valve (ESV) <br />ANNUAL TEST RECORD LOCATIONS AND TEST DATA <br />Emergency Shut Off (ESO) Testing Results <br />On 7 / z _ in accordance with "ESO Vendor Letter (3-21-05).doc' , from Valero's Retail <br />Compliance Department, as a part of annual compliance testing, this representative tested the <br />Emer enc Shut Off SO switches indicated on this sketch. Findings listed below: <br />Dispenser Emergency Shutoff Valve (ESV) Testing Results <br />On 3—lin accordance with NFPA 30A this representative tested the automatic -closing feature <br />of the Dispenser Emergency Shutoff VALVE(S) (ESV) located in the supply lines at thhe base of each <br />individual island type dispenser indicated on the diagram below. Each device (#) in all, <br />would automaticallyclose. Findings listed below: <br />Site Map Of Location and Placement of Devices Tested: <br />L--�J <br />C-7 <br />Signature Of Representative: <br />Testing /� /� <br />Company: /�/Y '✓IC W' d C f (i ii Date: <br />Location Name: Address: ��7�� s� City: State: <br />Store #: State ID #: <br />Z -43: <br />Emergency Shut Off (ESO) <br />If No, .Provide <br />" <br />{" E Y � � <br />Operational? <br />2 X136-� <br />Maintenance Log # <br />Date Called <br />��6 � �✓% <br />t��� <br />�/1 - <br />Emergency Shut Off (ESO) <br />If No, .Provide <br />Operational? <br />Maintenance Log # <br />Date Called <br />Disp. Emergency Shut Off <br />If No, Provide <br />Valve (ESV) Operational? <br />Maintenance Log # <br />Date Called <br />Tanknology Inc. 11000 N. MoPac Expressway, Suite 500, Austin, Texas 78759 <br />