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Triangle Environmental, Inc. <br />2525 West Burbank Blvd., Burbank, CA 91505-2302 <br />(88118)8840-70220 Fax: (818) 840-6929 <br />T.E.IVST FACILITY INSPECTIONIAUDIT <br />SHEET <br />Facility: Work #: 461006 <br />QUIKSTOP #00120 <br />9321 N. Thorton Rd. Test ate: 8/ 2/99 <br />STOCKTON, CA 95207 <br />County: San Joaquin <br />Cross Street: Waggoner Hts. (sic) <br />Status Type Cross Street: Number of <br />N— Not Present or Observed Disp. Hoses <br />C= Coaxial P= Pressure F= Flet <br />S= Satisfactory <br />D= Dual A= AngleCbeck M= Metalic Regular 2 4 <br />U= Unsatisfactory <br />N- No Stage I V= Vertical Check <br />Fill Cover: S <br />Fill Cap: S <br />Fill Cap Seal: S <br />Drop Tube: S <br />Strike Plate: T <br />V/R Cover: S <br />V/R Cap: S <br />V/R Seal: S <br />V/R Dry Break: S <br />Sub Pump: S <br />Sub Pump Cover: S <br />Overfill: S <br />Overfill Mfgr: EMCO <br />Comments: <br />Fill Type: D <br />Product Line Type: P <br />Tank Swing Joint Type: F <br />Dispenser Swing Joint Type: F <br />N= Not Present <br />S= Satisfactory <br />U= Unsatisfactory <br />Impact Valve: S <br />Vertical Check Valve: N <br />Fill Spill Containment: S <br />Fill Spill Mfgr: CNI <br />Dispenser Containment: S <br />Sub Pump Containment: S <br />Compliance Detail: (List items that need immediate attention.) <br />Plus: 2 4 <br />Premium: 2 4 <br />Diesel: <br />Kerosene: <br />Total # of Gas Nozzles 4 <br />® Stage II <br />B= Balance <br />A= Asist <br />System Type: B <br />Assist Mfgr: <br />