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0 0 <br /> I a Ron v4av&—IM 'N m" <br /> Tanknology Impact Valve FEB If 2016XP <br /> Inspection <br /> ENVIRONMENTA <br /> Impact Valve Operational 14EA.1-TH nPO4R"RfiI=""r <br /> Inspection <br /> Work Order: 2326364 Date: 2/10/2016 <br /> Site Name/ID: CHEVRON#208117 <br /> Address: 755 S.TRACY BLVD <br /> City: TRACY State: CA Zip: 95376 <br /> Dispenser Sec Valve <br /> Number [�1=11 Lock? Pass/Fail Comments <br /> 1/2 87 ry—i Fl (;',, Pass 0, Fail M Not Tested <br /> 1/2 91 FV-i TYF r Pass IT%- Fall ONE Not Tested <br /> 3/4 87 Fle-1 r— G Pass r- Fail®R Not Tested <br /> 3/4 91 rl—/j F G, Pass ON Fail rM Not Tested <br /> 5/6 87 P71 W! Of Pass r Fail G Not Tested <br /> 5/6 91 R-;" F! M, Pass 010 Fail 011 Not Tested <br /> 7/8 87 PF F G* Pass GO Fail 1 Not Tested <br /> 7/8 91 PF r- (; Pass rg Fall011,11 Not Tested <br /> 9/10 87 P7.11 rY7 GO Pass M, Fail 01a Not Tested <br /> 9/10 91 F- F (; Pass(7; Fail 0 Not Tested <br /> 11/12 87 R7 FF GF Pass 0 Fail OF Not Tested <br /> 11/12 91 171 FF Pass 0 Fail Not Tested <br /> Technician Comments: <br /> Technician Name: Gilbert Garcia <br /> Signature: 414aA�Zfl_ <br /> Environmental Compliance for Petroleum Systems <br /> @2016 Tanknology Inc.,Austin,TX All rights reserved.tanknology.com <br />