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N�RI:IIL <br />�xji•444a.. r r ti•rr.q <br />TP 201.3 <br />UST Static Pressure Performance Test Report Form <br />Permit Number: N-262 DATE 3/31/25 <br />Test Company: NOR -CAL TANK TESTING <br />Site Name: COUNTRYSIDE CHEVRON <br />Technician: DAVID WINKLER <br />Site Address: 14971 N HIGHWAY 88 <br />Certification Number <br />Expiration Date <br />City: LODI CA <br />District: SJV 0082 <br />3/31/26 <br />Pressure measuring device <br />I X digital manometer <br />TEST INFORMATION <br />Tank No. 1 2 3 <br />Total number of nozzles: 4 1 Are the tanks manifolded? X Yes <br />Phase I vapor recovery system executive order (as referenced on Permit to Operate) <br />VR -102 <br />Phase 11 vapor recovery system executive order (as referenced on Permit to Operate) <br />VR -202 <br />Nitrogen introduction point <br />X Phase I vapor coupler <br />15111 <br />Pressure measuring device <br />I X digital manometer <br />10433 <br />Calibration date for pressure measuring device (must be within 90 days of the test) <br />2/1/25 <br />Ending value for digital manometer drift test if applicable (must be 0.01 in. w.c. or less) <br />0 <br />Initial tank ullage pressure (vent if over 0.5 in. w.c.) <br />.28 <br />Nitrogen introduction flow rate, F (must be between 1 and 5 CFM) <br />2 CFM <br />Calculated ullage fill -time, t2 (t2 = V / 1522 x F) <br />10.25 <br />Actual fill -time <br />44SEC <br />Number of hoses with over 100 ml (balance hoses must be drained prior to testing) <br />0 <br />TANK INFORMATION <br />Tank No. 1 2 3 <br />4 <br />ALL <br />Product grade 87 91 <br />Initial Pressure, inches of water column (in. w.c.) <br />2.0 <br />Actual tank capacity (gallons) 10074 5037 <br />2.0 <br />15111 <br />Gasoline volume (gallons) 6646 3787 <br />Pressure at three minutes, in. w.c. <br />10433 <br />Ullage, V (gallons) 3428 1250 <br />1.97 <br />4678 <br />If tanks are not manifolded, number of nozzles <br />Allowable minimum pressure, in. w.c. <br />1.82 <br />2 IN. W.C. STATIC PRESSURE TEST <br />Test No. <br />1 2 3 4 5 <br />Start time <br />l OAM <br />Initial Pressure, inches of water column (in. w.c.) <br />2.0 <br />Pressure at one minute, in. w.c. <br />2.0 <br />Pressure at two minutes, in. w.c. <br />2.0 <br />Pressure at three minutes, in. w.c. <br />1.99 <br />Pressure at four minutes, in. w.c. <br />1.97 <br />Pressure at five minutes, in. w.c. <br />1.96 <br />Allowable minimum pressure, in. w.c. <br />1.82 <br />Pass / Fail (enter "GF" for gross failure) <br />I pass <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: _ <br />Date: 3/31/25 <br />Ver. 1.3 — 08.07.09 <br />