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Work Order: 2279402 <br /> [ESO)A(0 V)"Testing FoII13-Vcrsior+ I-12,9MIM <br /> Emergency Shut O SO) <br /> Dispenser Emergency Shutoff Valve (ESV) <br /> ANNUAL 'TEST RECORD LOCATIONS AND TEST DATA �1 <br /> Testing �ANkN—OLOGY -- <br /> company.- Date: t— E <br /> Location Naine: 'get)"'j Store#: 801-7 S. 41. 16 <br /> Address: J� G �]tV City: Ade State: { _ <br /> Emergency Shut Off ESQ Testing Results <br /> On o a.,t1_i i in accordance with"ESO Vendor Letter(3-21-05).doc",fivrn Retail Compliance <br /> Department, as a part of annual compliance testing,this representative tested the Emergency) Shut Off <br /> ESC})switches indicated on this sketclt. Findings listed below: <br /> Emergency$hut Off(ESO) IM,Provide <br /> Operations)? Maintenance-Log# Date Called <br /> Dispenser Emelt enc MOW Valve JESVJ Testing Results <br /> on p PL-"11--fL in accordance with NFPA 30A this representative tested the automatic-closing feature <br /> of the Dispenser Emergency Shutoff VALVE(S) (E-SV)located in the supply lines at the base of each <br /> individual island type dispenser indicated on the diagram below.Each device(#) / _in all= <br /> would automatically close. Findings li-cred below: <br /> Disp.Emergency-shut Off I ff No.Provide <br /> Valve(ESV)Operational? '�T a1ntenalice Log <br /> # Date Called <br /> 1 Tjje Map t)r:.fflcation and Plscamt of-Devito TastV`cl: <br /> +�[ 63V <br /> i `- <br /> i t r 2==AejowA <br /> FL <br /> r46 A =et r <br /> S � <br /> I <br /> Signature Of Representative: <br /> Tanknology Inc. 11000 N.MoPac Expressway,Suite 500,Austin,Texas 78759 <br />