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Impact Valve <br /> .-Ap Tanknology Inspection <br /> Impact Valve Operational <br /> Inspection <br /> Work Order: 2377273 Date: 2/10/2025 <br /> Site Name/ID: TESORO/SPWY XP#68152 <br /> Address: 401 W KETTLEMAN LANE <br /> City: LODI State: CA Zip: 95240 <br /> How Inspected: Line Test F NFPA 30A I— PEI RP1200 W Other (— <br /> Dispenser Secure Valve <br /> Number Grade Mount? Lock? Pass/ Fail Comments <br /> 1/2 87 '* r Pass F Fail I— Not Tested <br /> 1/2 91 F. r Pass r- Fail r- Not Tested <br /> 3/4 87 R r Pass r- Fail F Not Tested <br /> 3/4 91 r Pass F Fail r- Not Tested <br /> 5/6 87 W Fv-1 Pass r- Fail r Not Tested <br /> 5/6 91 r Pass r Fail I— Not Tested <br /> 7/8 87 F r Pass .F Fail r- Not Tested <br /> 7/8 91 F. P Pass r- Fail r- Not Tested <br /> Technician Comments: <br /> Technician Name: Carlos Zaragoza <br /> Signature: <br /> Environmental Compliance for Petroleum Systems <br /> ©2025 Tanknology Inc.,Austin, TX.All rights reserved.tanknology.com <br />