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wffm��,+ <br />SITE NAME: SHOP N GO <br />Address: 4511 PACIFIC AVE <br />City: STOCK TOTN—CA 95207 <br />Phone: 952-0001 <br />Contact: <br />Confirmation # <br />s "AWL.NJEKS 3 <br /># T07AL N07.ZLES 6 <br />A9ANIFOLDED: Yes <br />Fuel Grade <br /># Noceles per Tank <br />Actual Tank Capacity <br />Gasoline Volume <br />Ullage (Capacity aeaaa votame) <br />Phase I System Type: 2pt EVR Coy <br />Initial Test Pressure p.cn.a w.e.rl uo <br />PSI @ 2 Minutes <br />PSI @ 3 Minutes <br />PSI @ 4 Minutes <br />Final Pressure @ 5 Minutes p.m.a w.ut <br />No ❑ <br />E <br />El <br />C0 <br />416 2nd Street ® Dynamic Back Pressure Test <br />TP 201.4 <br />Galt, Ca. 95632 <br />(209) 744-0112 (800) 5249087 FAX (209) 744-0116 ® Static Pressure Decay Test <br />TP 2013 <br />TEST DATE: -5-8-17 UST AST C <br />TECHNICIANp- <br />NAM <br />David A Winkler SJV#0082 PT Startup Test X Compliance Test <br />Tank 1 <br />f declare, under penatty ofperjury under the laws of the state <br />r� s <br />91 <br />Of California that based on information and belief formed <br />Inspector: OCTAVIO <br />12032 <br />after reasonable inquiry, the statements and information <br />9604 1 <br />2364 <br />Provided in the document are true, accurate, and complete. <br />Present X Not Present <br />2.0 <br />TECH SIGNjt}ATURE: <br />2.0 <br />2.02 <br />2.02 <br />2.04 <br />2.06 <br />2.08 <br />Permit or Facility # N 30 <br />Time 3• <br />Make: WAYNE NOZZLE Make: NST <br />PV Valve Make: HUSKY <br />Model: Model: <br />Model 5885 <br />- BALANCE <br />ASSIST ❑ AssistTvoe: <br />Tank 1 <br />Tank 2 <br />87 <br />91 <br />6 <br />6 <br />12032 <br />8021 <br />9604 1 <br />2364 <br />2428 <br />5657 <br />Tank 3 Tank 4 TOTAL. <br />Initial pressure before testing- 0 " we <br />EQUIPMENT <br />j �L <br />6 <br />20053 <br />Decay: Blockage: <br />11968 <br />Incline Manometer ❑ Incline Manometer ❑ <br />8085 <br />Magnehelic Guage ❑ Magnehelic Guage ❑ <br />EVR <br />DigitalManometcrE]❑ Digita(Manometcr <br />2.0 <br />Equipment Calibration Date: 5-1-17 <br />Drift Check End Value: --(T- <br />Nitrogen Intro. Point: 2SCFH <br />Allowable Fill Time @ 2 scrim 5.20 <br />Time 1: <br />Time 2: <br />2.0 <br />2.02 <br />2.02 <br />2.04 <br />2.06 <br />2.08 <br />1.90 <br />Time 3• <br />PASS <br />Liquid Removal Check, Dynamic Back <br />Pressure (if due), and Parts & <br />Repairs Are Listed on Pace 2. <br />