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Work Order: 2271486 <br /> da <br /> 1p <br /> {ESO}&(ESV)Testing F©sin•vcmbn 4-12r91200M <br /> ergency Shut } <br /> Dispenser enser ergency Shutoff wave <br /> ANNUAL TEST RECORD LOCA.T'IONS AND TEST DATA. <br /> Testing TANKNOLOGY <br /> Company: Date, t <br /> Location Name: + stare#t: ?(,/7/ state 113 M 7Y31�� <br /> Address: j,/,6.33aU.FlG If Clty: "� state: <br /> Einer encu Shut Off(ESQ) Testing Results <br /> On ,21-i5-I0 in accordance with"ESO Vendor Letter(3(3 Z 1-a5).doe, from Retail Compliance <br /> Department, as a.part of annual compliance testing,this representative tested the Emergency Shut Off <br /> ESC switches indicated on this sketch. FindinM listed below: <br /> Emergency Shut Off(-SO) If No.Provide <br /> Operational? ' Y N Maintenanoe-Lang# date CalI td: _ <br /> Dispenser Enver ency Shutoff Valve (ESVI 'T`estin, .Results <br /> i -fS-/[GrG in acwrtlance with NFPA 30A flus represenEative tested the autorrfatEc-closing feature <br /> of the Dispenser Emergency Shutoff VALVE(S)(ESV)located in the supply Fines at the basc of each <br /> individual island type dispenser indicated on the diagram below.Each device(#) in all, <br /> would automadcall close. Pindin s listed below—. <br /> i)isj.Emer cy Shut{Off TFNo,Provide7 _71 <br /> Valve(ESV)Operational? Y N Maintenance Log# C►ate Galled <br /> Site ivtap of L ooatQ and Placument of *M Tested; �:crtw tem <br /> �► c�tTt3 � � � fid <br /> �t At1< K sa <br /> Ik � <br /> j '7'` eq)� <br /> i � , <br /> A: <br /> $ijMature,Qf Re resentative. <br /> Tanknology Inc. 11000 N.MoPac Expressway,Suite 500,Austin,Texas 78759 <br />