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W.O.# NW1-2308868 <br />Testing Company: <br />Location Name: <br />Address: <br />E <br />eso&ssv (v03_,W13>�, <br />b G I -t i Date: <br />Store #: <br />City: <br />A. Ein erzensx amt�off ( s ) Testinsr ReAtaity <br />State ID M <br />State: <br />Onin accordance with "ESO Vendor Letter (June 2011).docx", from Valero's Retail <br />CompliA�cecrtment. now CST Brands, Enc.'s Compliance Department, and NEPA 30A, as a <br />part of annual compliance testing, this representative tested the Emergency Shut Off (FSU) <br />button(s) indicated on the diagram below. ESQ must deactivate Submersible Turbine Pumps <br />(STY) and Dispensers. <br />cy Shut Off (ESO) If No, Provide <br />nal? N Maintenance Loe ii Date Called: <br />B. i,12gn er E Shmtgff'YaLve UFS s <br />On*tMispenser <br />n accordance with NFPA 30A this representative tested the automatic -closing <br />feature oEmergency Shut off Valves(s) (ESV) located in the supply lines at the base <br />of each individual island type dispenser indicated on the diagram below. Each device {#) <br />in all, would automatically close. <br />I)t* Emergency Shut Off If ivo, Providc <br />Valve (ESV) O rational? Y Maintenance Lo # pate Gaited ; <br />Tester Name- Tester Si nature; <br />