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n <br />Afforda—Telit <br />416 2nd Street <br />GIt, Ca. 95632 <br />® Drop Tube Integrity <br />(209) 744-0112 (000) 5249087 FAX (209) 7440116 <br />® Static Torque cit Rotation <br />TEST DATE: 5-8-17 <br />SITE NAME: SHOP N GO <br />TECHNICIAN NAME: <br />David A. Winkler SJV#0082 <br />AIR QIIALITY AGENCY: SJVAPCS <br />Site Address: 4511 PACIFIC AVE <br />City: STOCKTON CA 95207 <br />I declare, under penalty of perjury ander the laws of the state of <br />California that based on information and belief formed after <br />INSPECTOR NAME: <br />Phone: <br />reasonable inquiry, the statements and information provided in <br />the document are true, accurate, and complete. <br />X Present Not Present <br />Contact: <br />TECH SIGNATURE: <br />Stra1 ht ® Overfill Prevention Device <br />Permit Facility # N 30 Equipment: ❑ Incline Manometer ®Flow Meter Calibrated Daily <br />DROP TUBE & OVERFILL PREVENTION DEVICE PRESSURE INTEGRITY TEST <br />Drop Tube Drain Valve Pressure Test <br />Drop Tube Overfill Prevention Device Test <br />Flow Rate 80ml/min .17 <br />Flow Rate 200 ml/min .42 <br />"Corrected" Overfill Device Leak Rate <br />R -Regular <br />P=Plu s <br />Time to <br />reach 2" <br />H2O 80 <br />Drain Valve <br />Leak Rate <br />Final <br />Time to reach 2" Overfill <br />ll Leak <br />Final <br />Minus E uals <br />Overfill Device Drain Valve Corrected Lk Rate <br />S=Super <br />at <br />mUmin <br />2" 1420- 30 sec <br />Pressure <br />H2O at 200 ml rate <br />Pressure <br />2"x20 - 30 sec <br />Leak Rate Leak Rate for Overfill Device <br />Tank <br />Grade <br />mUmin <br />In H2O <br />(in sec) Umin <br />In H2O <br />mUmin ml/min mUtnin <br />161 0 <br />2,0 <br />PASS <br />91 <br />91 <br />175 0 <br />2.0 <br />PASS <br />4 <br />STATIC TOR UE & ROTATION <br />Vapor Adaptor: 1 2 <br />3 4 Product Adaptor: <br />1 2 3 4 <br />Brand: ®PW <br />Brand: ®PW <br />Model; <br />Model: <br />Product Grade: ___87 91 <br />Product Grade: <br />87 91 <br />Torque #1: 65 6$ <br />Torque #1: <br />55 1 70 <br />Torque #2: 65 65 <br />Torque #2: <br />55 70 <br />Torque #3: 65 C5 <br />Torque #3 <br />55 70 <br />Average: 65 65 <br />Average: <br />55 70 <br />360 Rotation YES YES <br />'4611 <br />