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Afforda—TeSt <br /> 4162"d Street Phone: (209)744-0112 <br /> Galt,Ca 95632 Fax: (209)744-011+6 <br /> affords softeom.net <br /> E.O.VR-201/202 <br /> Vapor-lo-Liquid(V/L)Volume Ratio Test Report Form <br /> Permit Number:N-3466-1-2 CONF# 12-14968 Test company:AFFORDA-TEST <br /> Site Name:GEORGE'S MINI MART Technician: ZANE NIMMO <br /> Site Address: 18662 N. HWY 88 Certification Nurnber Expiroilon Dole <br /> city: LOCKEFORD zip-.95237 District:S J V A P C D <br /> Date/Time of Test:5/15/12 Franklin(Healy):0563743702 12/8/12 <br /> TEST INFORMATION <br /> Gas volume meter type{i.e., Roots meter or tri-Tester) TRI PESTER <br /> Gas volume meter serial or identification number: 914644 <br /> Tri-Tester software version,if applicable(must be version 2.01) 2.96/2.01/DR <br /> Calibration date for Gas volume meter(must be within 180 days of the test) 2/1/12 <br /> Gas volume meter correction factor,y)Roots meter) 1 <br /> Pre-test leak check for Roots meter: Initial pressure: 30 sec.pressure: Pre-test leak check for Tri-testerTLAT Re-inflate in 30 sec.❑Yes® No <br /> Posi-test leak check for Roots meter: Initial pressure: 30 sec.pressure: Post-test leak check for Tri-fester:FLATRe-inflate in 30 sec.❑Yes® No <br /> initial - Final Total Gas Initial Meier Final Meier <br /> Node Fuel Nozzle Model 8,Serial Dispenser Dispenser Time Dispensing Poss/t=ail <br /> Number Grade No. ReadingReading Dispensed Reading(fi'j, Reading V/L ) <br /> g {sec) Rate(gal,) {P/F <br /> i al.. Gi (got,),Gfi (Jot.) V, {ftp),Ve <br /> I 87 HEALY 900 0.000 2.000 2.000 - 7.94 -- 1.10 PUSS <br /> 89 8.72 1.12 PASS <br /> 91 8.77 1.12 PASS <br /> 2 87 8.93 1.11 PASS <br /> 89 9.15 1.07 PASS <br /> 91 9.37 1.08 PASS <br /> 3 1 87 8.72 1.05 PASS <br /> 89 8.67 1.04 PASS <br /> I declare,under penalty of perjury under the laws of the state of California that based on information and belief formed after reosonabfe inquiry, the statements and information <br /> provided in the document are true, accurate,and complete. <br /> Signature of Technician: Date: 5115112 <br />