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Impact Valve <br /> Tanknology Inspection <br /> Impact Valve Operational <br /> Inspection <br /> Work Order: 2339111 Date : 1 / 17 /2019 <br /> Site Name/ ID : CHEVRON 208118 N -4087 - 1 -3 <br /> Address : 3355 E . HAMMER LANE @ HOLMAN RD <br /> City: STOCKTON State : CA Zip : 95212 <br /> Dispenser Secure Valve <br /> Number Grade Mount? Lock ? Pass / Fail Comments <br /> 1 /2 87 F F F Pass Fail Not Tested <br /> 1 /2 91 W r r Pass r Fail F Not Tested <br /> 3/4 87 r Pass r Fail r Not Tested <br /> 3/4 91 F lV F Pass F Fail F Not Tested <br /> 5/6 87 F F Pass r Fail F Not Tested <br /> 5/6 91 r Pass F Fail r Not Tested <br /> 7 /8 87 l� F Pass Fail Not Tested <br /> 7/8 91 IV 1 r Pass F Fail r Not Tested <br /> 9/ 10 87 W Pass r Fail F Not Tested <br /> 9/ 10 91 r F Pass F Fail r Not Tested <br /> 11 / 12 87 F Pass Fail Not Tested <br /> 11 /12 91 W Pass r Fail r Not Tested <br /> Technician Comments : <br /> Technician Name : Brent Bowen <br /> Signature : z� <br /> Environmental Compliance for Petroleum Systems <br /> ©2019 Tanknology Inc. , Austin , TX . All rights reserved . tanknology . com <br />