Laserfiche WebLink
Work Order: 2279365 <br /> FSO k FSV Fmn 106-21X191.10% <br /> 04 <br /> Emergency Shut Off (ESO) & <br /> Dispenser Emergency Shutoff Valve (ESV) <br /> ANNUAL TEST RECORD <br /> Testing Company: LLII — <br /> Uate: <br /> I.oeation Name: �G �/O Store#: 9� State ID#• __ <br /> Address: /Sy A S City; � State: 1 � 4 <br /> A.Emergency Shut Off(ESO) Testing Results <br /> On 2 4 e _ m accordance with `ESO Vendor Letter(6-25-09).docx",from Valero's Retail <br /> Com lia ce Department and NFPA 30A,as a part of annual compliance testing, this representative <br /> tested the Emergency Shut Off(ESO)switches indicated on the diagram below. ESO must <br /> deactivate Submersible Turbine Pumps(5PP)and Dispensers. <br /> Glmrgency Shut Off tESO) If No.Proviek <br /> Operational? N I Maintenaea.•c.Lug# Date Called: 1 <br /> B. Dispenser Emergency Shutoff Valve(FSV1 Testing Results <br /> Onto accordance with NFPA 30A this representative tested the automatic-closing <br /> fcatur o the Dispenser Emergency Shut off Valves(s)(ESV) located in the supply lines atdt use <br /> of each individual island type dispenser indicated on the diagram below. Each device(#)_ ____ <br /> in all, would automatically close. <br /> Dme <br /> iyp.Ergency Shut Off If No.Provide <br /> Valve(F-%V)Operational? N Maintenance ling M. <br /> � Siic AL1p Of Ii�alirnl mn1 Wa tmem of Ikrnes Tex4d lose addau+rul J1a7 rf 1acxwyr .J <br /> i <br /> i <br /> I <br /> Tester Name: /�" _ ��'� Tester Signature: <br /> Tanknology Inc. 11000 N.MoPac Expressway, Suite 500,Austin,Texas 78759 <br />