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Work Order: 2256287 <br /> fUSQ)&(LSV)Tcs1izzW Fom-Vwvi<m I.I.,W2001 <br /> Emergency Shut Off(ESO) & <br /> Dispenser Emergency Shutoff Valve (ESV) <br /> ANNUAL TEST RECORD LOCATIONS AND TE STDATA <br /> Testing <br /> Date: <br /> Loesdian Name.- I C(Atv fzotj d'0A I L"I Stem N: <br /> f-- taft ID# <br /> Address., Avt it", State: <br /> r <br /> Emergenev Shut OULIKSOITCS6139,Results <br /> On A <br /> .Aqj., <br /> B. in accordance with"ESU Vendor Letter(3-21-05).dee',from Valero's Retail <br /> Compliance Department,as a part of annual compliance testing,this representative tested the <br /> ,Emergency Shut Off(ESO switches indicated on this sketch. Hudings listed belo%;r.:."-F <br /> 4 IfNo.Provide <br /> Operational'' Maintenance Lo--, <br /> Dispenser Emergmij Shutoff Valve fEM Testing Results <br /> Onin accordance with NIFPA 30A this representative tested the automatic-closing feature <br /> Of tW�sp�n—w Emergency Shutoff VALVE(S)(ESV)located in the supply lines at the base of each <br /> individual island type dispenser indicated on the diagram below.Each device(#) in all, <br /> would automatically close.Findings listed below: <br /> Vatve(ESV)Operatiolmi? Y 0 iT3 cc Loy CAW- <br /> Disp-EniergencySIMIM If'No.ProOde <br /> N M 10=1 <br /> Site Map Oflzcmian and Pi cmemij-oiD'hes T4gafed <br /> 31q <br /> I-V <br /> off. <br /> Rinature Of Re[!reseSt;&(iye-/Z-------- <br /> Tanknology Inc. 8501 N.MoPac Expressway, Suite 400,Austin,Texas 78759 <br />