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Impact Valve <br /> .LAP Tanknology Inspection <br /> Impact Valve Operational <br /> Inspection <br /> Work Order: 2379671 Date: 5/19/2025 <br /> Site Name/ID: 7-Eleven 41530 <br /> Address: 1110 N Main St <br /> City: Manteca State: CA Zip: 95336 <br /> How Inspected: Line Test F NFPA 30A I- PEI RP1200 W Other F <br /> Dispenser Secure Valve <br /> Number Grade Mount? Lock? Pass/ Fail Comments <br /> 1/2 87 IV- Wo FY-1 Pass r- Fail F Not Tested <br /> 1/2 91 r rv- r Pass r- Fail F Not Tested <br /> 3/4 40 r FI-1 P Pass r- Fail r Not Tested <br /> 3/4 87 FV ry-1 P0 Pass r- Fail r- Not Tested <br /> 3/4 91 W r Pass r Fail r Not Tested <br /> 5/6 87 We r ry-1 Pass r- Fail I- Not Tested <br /> 5/6 91 P-1 r r Pass .F Fail r Not Tested <br /> 7/8 87 r r r Pass r- Fail r Not Tested <br /> 7/8 91 r ry-1 WO Pass F Fail F Not Tested <br /> 9/10 87 r rv- r Pass F Fail F Not Tested <br /> 9/10 91 We r FY-1 Pass F Fail F Not Tested <br /> 11/12 40 r r r Pass F Fail F Not Tested <br /> 11/12 87 r r P Pass F Fail F Not Tested <br /> 11/12 91 r r WO Pass F Fail I- Not Tested <br /> Technician Comments: <br /> Technician Name: Jesus Saldivar <br /> Signature: // '&�- <br /> Environmental Compliance for Petroleum Systems <br /> ©2025 Tanknology Inc.,Austin, TX.All rights reserved. tanknology.com <br />