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TANRNOLOGY CORPORATION INTERNATIONAL <br /> 10700 JERSEY BLVD. , SUITE 170 <br /> RANCHO CUCAMONGA, CALIFORNIA 91730 <br /> (714) 941-4491 — FAX (714) 941-7215 <br /> IMPACT VALVE TEST REPORT <br /> LOCATION: —re,�-c� Ol L CC) SERVICE STATION NO. : ,Zt Oz-74P <br /> L1g6 it) 6o4A C �TEST DATE: 4— 3-� <br /> COUNTY: TECHNICIAN: bf <br /> Corrected <br /> Yes No Date <br /> IMPACT VALVES <br /> v <br /> 1. Are remote pumping systems used? <br /> 2 . Are impact valves with fusible <br /> links installed under all X,� <br /> dispensers? <br /> 3 . Are the impact valve shear lines <br /> within ± 1/2" of the top of the <br /> PUMP block? �` <br /> 4 . Are the impact valves secured p►�� <br /> to the pump island? <br /> r� <br /> 5 . Does the impact valve open and <br /> close easily? <br /> i <br /> 6. Is the area immediately around <br /> the impact valve linkage clear <br /> of dirt, sand or gravel? <br /> 7 . Is each impact valve free of <br /> any device that may prevent 1 / <br /> its proper operation? <br /> 8 . Does the impact valve stop all <br /> product flow when closed? <br /> 9 . Are there any visible leaks, 7�f <br /> weeps or sweating joints at <br /> the impact valve? V <br /> 10. Is the dealer satisfied that <br /> all of the impact valves are <br /> operating properly? <br /> Remarks: <br /> SMG/smp/3-31 <br />