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A& �t 416 2"Street Phone: (209)744-0112 <br /> Galt,Ca 95632 Fax: (209)744-0116 <br /> afforda softcom.net <br /> E.O.VR-201/202 <br /> Vapor-to-Liquid(V/Q Volume Ratio Test Report Form <br /> Permit Number:N-1131 Test Company:AFFORDA-TEST <br /> site Name:ONE STOP MARKET Technician: ZANE NIMMO <br /> Site Address: 1151 W LOUISE AVE Certification Number Expiration Date <br /> city: MANTECA, CA zip:95336 District:S J V A P C D <br /> Date/Time of Test:6/3/2020 Franklin(Healy):1009843708 1/10/2021 <br /> TEST INFORMATION <br /> Gas volume meter type (i.e.,Roots meter or Tri-Tester) TRI TESTER <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) 2/26/2020 <br /> Gas volume meter correction factor,y(Roots meter) 1,001 <br /> Pre-test leak check for Roots meter: Initial pressure: 30 sec.pressure: Pre-test leak check for Tri-testerYLAT Re-inflate in 30 sec.❑Yes®No <br /> Post-test leak check for Roots meter: Initial pressure: 30 sec.pressure: Post-test leak check for Tri-testerYLAT Re-inflate in 30 sec.❑Yes® No <br /> Initial Final Total Gas Initial Meter Final Meter <br /> Nozzle Fuel Nozzle Model&Serial Dispenser Dispenser Time Dispensing Pass/Fail <br /> Number Grade No. ReadingReading Dispensed sec Rate Reading(ft3), Reading V/L <br /> 9 (gal.) (sec) (gal.) V (ft3),Vr (P/F) <br /> (gal.),G (gal.),Gr <br /> 1 87 HEALY 900 0.000 2.000 2.000 -- 6.17 -- -- 0.96 PASS <br /> 89 7.11 0.99 PASS <br /> 91 1 7.39 0.97 PASS <br /> 2 87 6.79 0.97 PASS <br /> 89 7.39 0.97 PASS <br /> 91 7.67 0.97 PASS <br /> I declare, under penalty of perjury under the laws of the state of California that based on information and belief formed after reasonable inquiry, the statements and information <br /> provided in the document are true,accurate,and complete. <br /> REsIEE i V I- L J <br /> Signature of Technician: Date: 61312020 .J U iN 12 2120 <br /> ENVIRONMEN IAL HEALTH ver. 1.0— 12.26.07 <br /> DEPARTMENT <br />