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4-w Tanknology Impact Valve <br /> Inspection <br /> Impact Valve Operational <br /> Inspection <br /> Work Order: 2335977 Date: 7/17/2018 <br /> Site Name/ID: Fed Ex Ground <br /> Address: 120 S Hansen Road <br /> City: Tracy State: CA Zip: 95304 <br /> Dispenser Secure Valve <br /> Number Grade Mount? Lock? Pass/ Fail Comments <br /> 1/ 40 W W Pass F Fail F Not Tested <br /> 5/6 40 W I- Pass F Fail F Not Tested <br /> 7/8 40 Wo F R Pass r— Fail F Not Tested <br /> 1 SAT/2 40 Wo R P Pass i- Fail F Not Tested <br /> 2 SAT/3 40 P-1 FY-1 Pass F Fail F Not Tested <br /> 3 SAT/4 40 W W Pass F Fail F Not Tested <br /> 4 SAT/ 40 W FV- Pass F Fail F Not Tested <br /> Technician Comments: <br /> Technician Name: Brent Bowen <br /> Signature: <br /> Environmental Compliance for Petroleum Systems <br /> ©2018 Tanknology Inc.,Austin,TX.All rights reserved.tanknology.com <br />