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S J0 aquin <br />an ff Vail" <br />AIR POLLUTION CONTROL DISTRICT <br />�;-tatic Torque of Rotatable Phase I Adaptors Report Form <br />Permit Number; Test Company: BZ SERVICE STATION MAINT <br />Site Name: ECONO GAS Technician: ED STEARNS <br />SiteAddress: 880 VICTOR ROAD certification Number Expiration Date <br />City: _LODI ZIP: District-, <br />Date 'ime of Test: 8-10-09 130PM <br />Measurement units: 0 pound -Inch [I <br />vaeor Ads for I <br />Brand: OPW <br />'Miodel. 61 VSA <br />Product grade: 87 <br />Torque 1.- 48 <br />Torque 2- 48 <br />Torque 3: 48 <br />Average: 48 <br />360' rotation: Yes CM No [i <br />— Product Adaptor I <br />Brand: OPW <br />Model' 61SALP <br />Product grade: 87 <br />Torque 1: 27 <br />Torque 2: _28 <br />Torque 3: 27 <br />Average: 27 <br />360' rotation: Yes 0 _N0 0 <br />Vapor Adaptor 2 <br />Brand. OPW <br />Model.61 VSA <br />Product grade, 91 <br />Torque 1: 40 <br />Torque 2: 39 <br />Torque 3: 43 <br />Average: 41 <br />350* rotation: Yes No C] <br />Product M!qt_or2 <br />Brand: OPW <br />Model: 61 SALP <br />Product grade: 91 <br />Torque 1., 36 <br />Torque 2: 36 <br />Torque 3: 34 <br />Average: 35 _0No Ei <br />360' rotation: _Yes <br />UKI <br />R] <br />Brand, <br />Model: <br />Product <br />Torque 1: <br />Torque 2: <br />Torque 3: <br />3600 rotation: Yes F-1 No Li 13600 rotation: Yes [3 No [:I <br />360* rotation: YL-$ 0 No El <br />Product Ada for 4 <br />Brand: <br />Model:_ <br />Product grade: <br />Torque 1: <br />Torque 2: <br />Torque 3: <br />Average: <br />360' rotation: Yes Ei No 0 <br />/ declare, under penalty Of perjury under the laws of the State of California that based on information and belief <br />funned after reasonable inquiry, the statements and information provided in the document are true, accurate, <br />and complete. <br />Signature of Technician: Date: -ro -dj <br />NQUVIS DIAHaS Z9 09CZ TLC 9T6 XVd fT:OT OT09/80/TO <br />