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gn416t 2"1 Street <br /> Galt, CA 95632 <br /> (209) 744-0113 Fax (209) 744-0116 <br /> E.O.VR-203/204 <br /> Veeder-Root Vapor Polisher Operability Test Form <br /> Permit Number: N3451-1-2 Date of Test: 05-28-20 Time: 1100 <br /> Site Name: EL DORADO GAS MART <br /> Site Address: 1605 ELDORADO ST <br /> City: STOCKTON, CA Zip: 95206 Technician: FELIX RAMIREZ <br /> District: BAY AREA Veeder-Root: B34976 <br /> TEST INFORMATION <br /> Calibration date for digital manometer(must be within 6 months of the test) 03-01-20 <br /> Ending value for digital manometer drift test(must be 0.01 in.w.c. or less) 0 <br /> Calibration date for thermometer(must be with 6 months of the test) NA <br /> Vapor polisher valve close date and time(must have been closed for at least 2 hours) 05-28-20 1 815 <br /> Atmospheric pressure sensor serial number 4755 <br /> PRESSURE INTEGRITY TEST <br /> Nitrogen gas flow rate(scfh) 18 SCFH <br /> Starting pressure(in.w.c.) 8.06 <br /> Final pressure at 1 minute(in.w.c.) 8.09 <br /> Is the final pressure>7.0 in.w.c.? Yes <br /> Is the difference between the starting and final pressure<0.5 in.w.c.? Yes <br /> NOTES: 'If the final pressure is not > 7.0 in. w.c. and the difference is not < 0.5 in. w.c., then the vapor polisher is not in <br /> compliance. <br /> FLOW TEST <br /> Nitrogen gas flow rate(scfh) 18 SCFH <br /> Pressure(in.w.c.) 1.88 <br /> Is the pressure between 1.69 and 2.25 in.w.c.? Yes <br /> NOTES: 'The flow rate must be 18.0 f 0.2 scfh. <br /> 'The pressure must be between 1.69 and 2.25 in.w.c.or the vapor polisher is not in compliance. <br /> 'Three-way valve must be returned to normal(open)operating position after testing is completed. <br /> 'PMC valve mode must be re-set to automatic after testing is completed. <br /> I declare, under penalty of perjury under the laws of the state of California that based on information and belief formed <br /> after reasonable inquiry, the statements and information provided in this document are true, accurate, and complete. <br /> Signature of Technician: Date: 05-28-20 <br /> Ver. 1.1—01.20.09 <br />