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01/21/2013 00:33 9169397492 CEMEX - ENVIRO PAGE 02/08 <br /> r <br /> Standing Loss Control EVR Installation Equipment Check List <br /> Installing Products per ARB Executive Order VR.801-D <br /> Site Location :(name) Ge aeac -Km�l� ar <br /> Address: <br /> City/State: <br /> Contact/Phone:_ gti + y� 9 tT3 - /�'f <br /> Installing Contractor-.:(name) - �- <br /> 13�a�� Address: <br /> Clty/State: c�z, V, y- <br /> (V/ Contact/Phone; E / 7 Z7_._y� --78' 7z- <br /> Tank Number: Product: Capacity: <br /> Tank Number: Product: Capacity: <br /> Tank Number: Product: Cap ity: <br /> Installing Technician: (name): <br /> Technician Certification Nuber. <br /> Signature: <br /> Yes/No Initials 1. Is all of the installed equipment for Standing Loss Control <br /> y EVR listed in ARB Executive Order (E.O.)VR-301-D? <br /> Note: All Standing Loss Control Vapor Recovery installed <br /> equipment must be listed in E.0, VR-301-D. See <br /> attached Exhibit 1 Checklist, and !check each item <br /> installed. <br /> Yes/No Initials 2. Pressure Vacuum Vent Valve <br /> Is there a PN Vent valve installed on the top of each <br /> (gasoline) vent pipe (a maximum of three EVR PN valves <br /> per GDF) or manifold? <br /> a. PN vent valve(s)torqued to rJ0 ft. lbs. <br /> YeslNo Initials 3. White Paint <br /> y�5/ <br /> V Has the aboveground storage tank surface been prepared according to the white paint manufacturer's specifications? <br /> a. Describe surface preparation: I r � <br /> Installation, Operation and Maintenance Manual, Executive Order VR-305-0 <br /> Standing Loss Control Vapor Recovery System for Existing Installations of AST <br /> Page 6 <br />