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Triangle Environmental, Inc. <br />2525 West Burbank Blvd., Burbank, CA 91505-2302 <br />(818) 840-7020 Fax: (818) 840-6929 <br />T.E.I. UST FACILITY INSPEC'TI®NIAUDIT SHEET <br />Facility: Work : 460982 <br />QUIKSTOP #00138 <br />1153 LINCOLN BLVD Test ate: 8/ 8/99 <br />TRACEY, CA 95376 <br />County: SAN JOAQUIN <br />Cross Street: <br />Status Type Cross Street: Number of <br />N= Not Present or observed Dlsp. Hoses <br />C= Coaxial P= Pressure F = Flex <br />S= Satisfactory <br />D= Dual A= Angle Check M= Metalic Regular: 2 4 <br />U= Unsatisfactory <br />N= No Stage I V= Vertical Check <br />Fill Cover: <br />S <br />Fill Cap: <br />S <br />Fill Cap Seal: <br />S <br />Drop Tube: <br />S <br />Strike Plate: <br />G <br />V/R Cover: <br />S <br />V/R Cap: <br />S <br />V/R Seal: <br />S <br />V/R Dry Break: <br />S <br />Sub Pump: <br />S <br />Sub Pump Cover: <br />S <br />Overfill: <br />S <br />Overfill Mfgr: EBW <br />Comments: <br />Fill Type: D <br />Product Line Type: P <br />Tank Swing Joint Type: F <br />Dispenser Swing Joint Type: F <br />N= Not Present <br />S= Satisfactory <br />U= Unsatisfactory <br />Impact Valve: S <br />Vertical Check Valve: N <br />Fill Spill Containment: S <br />Fill Spill Mfgr: OPW <br />Dispenser Containment: S <br />Sub Pump Containment: S <br />Compliance Detail: (List items that need immediate attention.) <br />Plus: 2 4 <br />Premium: 2 4 <br />Diesel: <br />Kerosene: <br />Total # of Gas Nozzles 12 <br />® Stage II <br />B= Balance <br />A= Asist <br />System Type: B <br />Assist Mfgr: <br />