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NORCAL TANK TESTING <br /> 877 BATEMAN WAY <br /> GALT CA 95632 <br /> E.O.VR-204 <br /> Veeder-Root In-Station Diagnostics Site Shutdown Test Report Form <br /> Permit Number:N-633 DATE 6/13/25 <br /> Site Name: PERSHING GAS FOR LESS S1V 0082 EXP 03/31/26 <br /> Site Address: 4445 N PERSHING <br /> City: STOCKTON CA Technician: DAVE WINKLER <br /> Veeder-Root: B34975 07/21/26 <br /> ir <br /> SITE SHUTDOWN TEST' <br /> Test Parameter Test Result (Y/N) <br /> Was power removed from the TLS-350 console? YES <br /> Was power to the submersible pump(s)removed by the TLS-350? YES <br /> Was power restored to TLS-350 console? YES <br /> COMMENTS (Include Description of Repairs Made) <br /> NOTES: 'A certified Veeder-Root technician must perform this test. <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: 6/13/25 <br /> Ver. 1.0—09.18.08 <br />