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Work Order: 2272128 <br /> MW <br /> (ESO)&(ESV)Testing Form-version 1-2/8/2010 <br /> Emergency Shut Off( ) <br /> Dispenser Emergency Shutoff Valve <br /> ANNUAL TEST RECORD LOCATIONS AND TEST DATA <br /> Testing TANKNOLOGY <br /> Company: Date: V <br /> Location Name: 6f'/'�4vp'N store#: 04313 state ID#: <br /> Address: !`��(� Lam• 1'r/aL City: filtlk l state: CA <br /> Emergency Shut Off ESQ Testing Results <br /> On in accordance with"ESO Vendor Letter(3-21-05).doc",from Retail Compliance <br /> Department,as a part of annual compliance testing,this representative tested the Emergency Shut Off <br /> SO switches indicated on this sketch.Findings listed below: <br /> Emergency Shut Off(ESO) I I If No,Provide <br /> Operational? J �V <br /> 'N. Maintenance Log# Date Called <br /> Dis2enser,Emergenev Shutoff Valve ESV Testing Results <br /> On Z in accordance with NFPA 30A this representative tested the automatic-closing feature <br /> of the Dispenser Emergency Shutoff VALVE(S)(ESV)located in the supply lines at lbebase of each <br /> individual island type dispenser indicated on the diagram below. Each device(#) 7t3li in all, <br /> would automatically close.Findings listed below: <br /> F--Ms—p.Emergency Shut Off If No,Provide <br /> Valve(ESV)Operational? N Maintenance Log# Date Called:� I -A <br /> Site Map Of Location and placement of Devices Tested: <br /> � <br /> L V, i iso <br /> `4 `¢ <br /> L� <br /> Ito t l t <br /> G� c2 � t � <br /> rD1 <br /> 0 <br /> ® ctS" <br /> 4 <br /> c L 6,- <br /> Signgtgrg Of Re resentati : <br /> Tanknology Inc. 11000N.MoPac Expressway,Suite 500,Austin,Texas 78759 <br />