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Work Order: 2258139 <br />(ESO) & tl:Svq'r Form - V—ion l- 711 0120M <br />I <br />I <br />Emergency Shut Off (ESO) & <br />Dispenser Emergency Shutof(Valve (ESV) <br />ANNUAL TEST RECORD LOCATION AND TEST DATA <br />Testing <br />Co 14 ' e o Datil: -7Location Name: St #: St.�ete ID #: AAA <br />Emergency Shut Off (ESO) Testing Results <br />On )--10 -OK in accordance with "ESO Vendor Letter (3-21 05).doc", from Retail Compliance <br />ff <br />Department, as a part of annual compliance testing, this represe*tative tested the Emergency Shut O <br />(ESO) switches indicated on this sketch. Findings listed below: <br />I <br />Dispenser Emergency Shutoff Valve (ES Tesjing Results <br />On -7-10- in accordance with NFPA 30A this representative tested the automatic -closing feature <br />of the Dispenser Emergency Shutoff VALVE(S) (ESV) located .n the supply lines at the base of each <br />individual island type dispenser indicated on the diagram below; Each device (#)_ in all, <br />would automaticallyclose. Findings listed below: <br />Disp. Emergency -Shut Off If No, Provide <br />Valve {ESV) Operational-' - Maintenance Log # Date Called: <br />Site Map Of Location aad Placement of Devices Test <br />x �o <br />i <br />i <br />i <br />1 <br />Signature Of Representative: <br />i <br />I <br />Emergency Shut Off {ESO) <br />G.{� <br />[f Tao, Provide <br />1 � <br />Operational'' <br />Maintenance Log # <br />Address: <br />Cit), <br />�ro�.x. <br />slate: <br />Emergency Shut Off {ESO) <br />[f Tao, Provide <br />Operational'' <br />Maintenance Log # <br />Date Called <br />Tanknology Inc. 8501 N. MoPac Expressway, Suite 400, Austin, Texas 78759 <br />