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j 416 2" Street <br /> o d r a-WTe t Galt, CA 95632 <br /> (209) 744-0113 Fax (209) 744-0-116 <br /> E.O. -204 <br /> Veeder-Root In-Station Diagnostics Balance or Flow Meter Operability Test Procedure <br /> J � <br /> Permit Number: N97-1-5 Date of Test: 09-12-17 <br /> Site Name: Tiwana Gas& Food o <br /> Site Address: 1210 HAMMER LANE5 `�' <br /> City: STOCKTON CA Zi 95213 <br /> f Technician: Felix Ramirez <br /> _ VST: 1361 �° <br /> District: SJAVP NORTH Veeder-Root: B34976 $ <br /> "bb• ¢ v `.s-. da°d', s`; + n, r w'`' ate' �r,::a h°.. ea �"�• `,^,`_ Calibration Date. 01-18-17 <br /> 0 <br /> e ! �F, :➢ t d ` .7 `' 8A73 J sa -Q` e L 00. J. <br /> � 5 <br /> A <br /> a ..�,. ^ a I�f3ry hx�r�2,w:.,,o- {.;'ct�n .. ,.._..". f� :fid p4e F B `, aAa'� Z t,• 1( a e 4 .�.a <br /> 60402 1-2 9442.5,03 9450,072 7.569 4390 4490 1 7.481 1.1 Pass <br /> 37717 3-4 9126.121 9133.577 7.456 4490 4590 1 7.481 0,0 Pass <br /> 35332 5-6 _ 6172.047 6179,666 7.619 4590 4690 1 7.481 1.8 Pass <br /> 34865 7-8 4033.134 4040.716 7.582 4690 4790 1 7.481 1.3 Pass <br /> N <br /> _.__.. ..._ co <br /> co <br /> co <br /> ISD_Difference —Gas Flow Meter- Difference C-- <br /> Gallons " <br /> =Cubic Feet x 7.481 %Difference "°l�°"` — — x I OW- .x <br /> Gas_Flow_Meter_Difference <br /> gQuos <br /> I declare, under penalty of perjury under the laws of the state of California that based on information and belief formed after reasonable inq� the a <br /> statements and information provided in this document are true, accurate, and complete. <br /> Si nature of Technician: <j ` -1 <br /> g Date: 09-12-17 <br /> Ver. I,!1...-09,1SA'{ <br />