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Work Order: 2263513 <br /> (ESO)&(ESV)Testing Form-Version t-317,'2007 <br /> Emergency Shut Off (ESO) <br /> Dispenser Emergency Shutoff Valve (ESV) <br /> ANNUAL TEST RECORD LOCATIONS AND TEST DATA <br /> Testing � 1 ------� <br /> Com v: Date: --- <br /> Location Name: tV")-) Store#: 0/0"I State ID <br /> Address- tip(p11 j (oc Aryk City ew State_ ---- <br /> Emergency Shut Off ESO Testing Results <br /> On .11#jIgA in accordance with"ESO Vendor Letter(3-21-05).doe',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. Findings listed belovv: <br /> 7E, rL�ency Shut 011'(ES0) �ftfo.Provide <br /> Operational'? N enance Log Date Called <br /> Dispenser Emergency Shutoff Valve (ESV) Testing Results <br /> On 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 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 /> Disp.Emergency Shut Ott If No.Prop ide <br /> valve(ESS')Operational'? Y N Maintenance Log� Datc Cailed <br /> Site Map Of L)c9ion and Placement of Devic . rested: '� $( �4, <br /> t6Y <br /> gstaA <br /> V <br /> D <br /> Signature Of Representative: <br /> Tanknology Inc. 8501 N.MoPac Expressway,Suite 400,Austin,Texas 78759 <br />