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All—], ?.?rlrll I;q <br />(ES01 & CESAO Tc0trig Fawn - VCnim I- ;2/1W2M9 <br />Fm'%T Shut 0-0 (FSO ) & ergen%I-.,y TIN— . <br />Dispenser Emergency Shutoff Valve (ESV) <br />ANN -UAL TEST RECORD LOCATIONS AND TEST DATA <br />Tester �TANKNOLOGY �- 'T <br />COMP Lny:Date: <br />-- <br />Location NAMC Lid Store State 717 V., <br />Address; State; <br />Amer enc Shut Off qLSO) jesting Results 5).cloel, from Ret Complianco <br />()n L-2 5, t in accordance with "ESO Veridor Lester (3-21 -0 <br />Department. as a part of annual compliance testing, this representative tested the Emergency Shut Off <br />�ESO ) switelles indicated on this sketch. Findings listed below: <br />Emergency Shut Off (ESC}) if Ne I Provide <br />I <br />Opomtional'i <br />MEji tenance Log ii Date called" <br />M N <br />�Vj <br />on Qs ve tested the autowatic-10f09ing feawm <br />,�Ej-z,oq in accordance with NEPA 30A this representative 3 <br />of the Dispenser Emergency Shutoff VALVE(S) (ESV) located in the supply lines at the base of each <br />individual island type dispenser indicated on the diagram below- Each device (4) U in all, <br />would automaticali close. iistedbelow': <br />L"3"' <br />Mmaititeim" Los <br />Shut Off 0 <br />Emergency <br />V, YJ <br />Valve(ESV)Oporationa17 _T —Date <br />Called <br />Disp. ETnergeucy Shut Off If No, Provide <br />Y* N �el= �Ls# <br />Of 1,0cation <br />S' nature Qf Rcl2resentative: 9&d <br />hi Ara, 111 <br />Tanknology Inc. 8501 N. MoPac Expressway, Suite 400, Austin, Texas 78759 <br />