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'Nlorda,,,' ' ( ,EN -4162 nd Street Phone:(209)744-0112 <br /> as/ Galt,Ca 95632 Fax: (209)744-0116 <br /> affords softcom.net <br /> :0. VR-202 <br /> INCON In-Station Diagnostip Di o TS%utdown Mapping Verification Test <br /> & Vapor Flow Meter V/L Check Test Report Form <br /> Permit Number:N-1159-1-3 CONF# 15-20467 Test Company: AFFORDA-TEST <br /> Site Name: MANTECA EXPRESS MART Technician: ZANE A.NIMMO <br /> Site Address:419 S. MAIN ST. Certification Number Expiration Date <br /> City: MANTECA Zip:95337 District: 5168333760 <br /> Date/Time of Test: 5/28/2015 <br /> DISPENSER SHUTDOWN MAPPING VERIFICATION TEST <br /> Dispenser fueling point numbers FP: 1 FP: 2 <br /> Test Result (Y/N) <br /> Dispenser was shutdown'? Y <br /> Fuel was unable to be dispensed from fueling points associated with the dispenser? Y <br /> Dispenser was re-enabled? Y <br /> Fuel can be dispensed from fueling points associated with the dispenser? Y <br /> VAPOR FLOW METER V/L CHECK <br /> Vapor flow meter serial number 0842264 <br /> Dispenser fueling point numbers FP: 1 FP: 2 <br /> Low grade V/L result#1 1.09 1.06 <br /> ISD V/L value#1 1.12 1.08 <br /> Difference between V/L result#1 and ISD V/L value#I (V/L—ISD V/L) .03 .02 <br /> Pass/Fail(Pass=difference within±0.15), if fail continue PASS PASS <br /> Low grade V/L result 42 <br /> Low grade V/L result#3 <br /> Average of 3 V/L results <br /> ISD V/L value#2 <br /> ISD V/L value#3 <br /> Average of 3 ISD V/L results <br /> Difference between Average V/L and Average ISD V/L values <br /> Pass/Fail(Pass=difference within±0.15) <br /> 1 declare, under penalty of perjury under the laws of the state of California that based on information and belief formed <br /> after reasonable inquiry, the statements and information provided in this document are true, accurate, and complete. <br /> Signature of Technician: _ Date: 5/28/15 <br /> V cr. L_ 08'.u5 fj8 <br />