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NORCAL TANK TESTING <br />877 BATEMAN WAY <br />GALT CA 95632 <br />TP -201.4 <br />Dynamic Back Pressure Test Report Form <br />Permit Number: N-262 DATE 3/31/25 <br />Test Company: NORCAL TESTING <br />Site Name: COUNTRYSIDE CHEVRON <br />Technician: David Winkler <br />Site Address: 14971 N HIGHWAY 88 <br />Certification Number <br />City: LODI CA <br />District: SJV 0082 3/31/26 <br />Back pressure test assembly leak check (must decay < 0.2 in. w.c. in 5 min. at 50% of the scale of the ® pass ❑ Fail <br />assembly's highest range) <br />G-70-191 (Healy ORVR) <br />TEST INFORMATION <br />Phase II vapor recovery system executive order (as referenced on Permit to Operate) VR -204 <br />Pressure measuring device <br />I <br />I X mechanical gauge <br />Calibration date for pressure measuring device (must be within 90 days of the test) 2/1/25 <br />Ending value for digital manometer drift test if applicable (must be 0.01 in. w.c. or less) 0 <br />0.50 @ 60 CFH <br />Back pressure test assembly leak check (must decay < 0.2 in. w.c. in 5 min. at 50% of the scale of the ® pass ❑ Fail <br />assembly's highest range) <br />BACK PRESSURE LIMITS (in. w.c.) BY EXECUTIVE ORDER FOR PRE -PHASE II EVR <br />SYSTEMS <br />G-70-52 (balance for AST & UST) & G-70-139 (Hirt VCS -200) <br />0.15 @ 20 CFH <br />0.45 @ 60 CFH <br />0.95 @ 100 CFH <br />G-70-177 & 181 (Hirt VCS -400) <br />0.50 @ 60 CFH <br />G-70-191 (Healy ORVR) <br />0.50 @ 60 CFH <br />BACK PRESSURE LIMITS (in. w.c.) BY EXECUTIVE ORDER FOR PHASE II EVR SYSTEMS <br />VR -201 & 202 (Healy Phase II EVRI <br />0.50 @ 60 CFH <br />VR -203 (VST balance Phase II EVR) <br />0.35 @ 60 CFH <br />0.62 @ 80 CFH <br />Nozzle Fuel Grade 20 CFH 60 CFH 80 CFH 100 CFH <br />Number <br />1/2 .04 <br />3/4 .06 <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: 3/31/25 <br />Ver. 1.3 — 08.07.09 <br />