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Work Order: 2266831 <br /> f6soj&jcsv)-rmtasv.f-onis-1,'crwo 1-!2;fj.?NH"F <br /> Emergency Shut Off(ESO) & <br /> Dispenser Emergency Shutoff Valve (ESV) <br /> ANNUAL TESTRE.-CORD LOCATIONS AND TEST DATA 7 <br /> Testing 1 YK N- KNOLOGY <br /> Date: <br /> Store ft- 36,117 1 State 11)9: <br /> Location Name, 5 <br /> state: <br /> Address: <br /> JCity:- <br /> Emergenel Shot Off(ESQ) Testing Results <br /> ail Compliance <br /> dt �jaccordancc with"ES6 Ven wTr Letter 3-21-05).doc from Ret J <br /> Department.as a part of annual compliance testing.this representative tested the Emergency Shut Off <br /> (ESO)swilelles,indicated on this sketcb-Pindings listed below: <br /> - <br /> Enivol <br /> ortcy slut OTTi.F Provide <br /> OperauonaP N Maimemns L;Log I Date Calkd <br /> Dispenser Emergenev'Shutoff Valy ts <br /> OnN-fo,vl in accordance%A-ithN-FPA 30A this representative tested the aiit(sniatic-ci(f,,,-ilig)t:4Lusle <br /> ;c of each <br /> hutoff VALVE(S)i USV)located in the supply'I ints at rhe ba, <br /> of the Dispenser 1-.m,�rgency S supply'. . - -14? in ail.. <br /> individual island type dispenser indicated on the diagram below. Each device(4)-,7.. f <br /> would auMmaticalh,Close.Fi-ildings listedw <br /> belo . <br /> Disp.Erneqqvno S' DA' <br /> TI No.T,-cr ide <br /> Valk, Mahslemmcc Log k Date Called: <br /> e(ESVI Ope:i <br /> owl' <br /> �-Ac-,.I,,r T�: <br /> rAP <br /> (A) <br /> X <br /> )A <br /> PC <br /> !ql 0 X <br /> i <br /> t <br /> sigagure Of Representative: <br /> Tanknology Inc.8501 N.MoPac Expwy#400,Austin,Texas 78759 <br />