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4 <br /> San Joaquin VEALTHY AIR LIVING' <br /> www.heal thyairliving.com <br /> AIR POLLUTION CONTROL DISTRICT Make one change for clean air! <br /> TP-201.6C or EVR Liquid Removal Test <br /> Liquid Removal Rate Report Form <br /> Permit Number:N-292 Test Company:AFFORDA TEST <br /> SITE NAME: SHORT STOP Technician:DAVE WINKLER <br /> Site Address:20 WEST TURNER LANE Certification Number: 0082 Expiration Date: 2020 <br /> City:LODI,CA Zip:95240 District: SJV <br /> Date/Time of Test: 7-9-18 VST(if applicable):30001531961 2018 <br /> TEST INFORMATION <br /> Phase II vapor recovery system executive order: ❑ G-70-52(Pre-Phase H EVR balance for AST&UST) ❑ VR-203/204(VST Phase II EVR balance) <br /> EVR Short VI G T Dispensing VF Wi Wr VW VI—VW—VF <br /> Nozzle Fuel Version** Rate G <br /> Number Grade Volume of Gas added to hose Gallons Time to G x 60 Gas drained Gas introduced Gas Liquid removal Pass/Fail <br /> Gas drained (150—175 ml) dispensed dispense T after after dispensing recovered Wi-Wr rate(mUgal) <br /> from hose(ml) see. dis ensin 150—175 ml <br /> 1 87 0 PASS <br /> 2 87 0 PASS <br /> 3 87 0 PASS <br /> 4 87 0 PASS <br /> 5 87 0 PASS <br /> 6 87 0 PASS <br /> 7 1 87 0 PASS <br /> 8 87 0 PASS <br /> 1 declare, under penalty of perjury under the laws of the state of California that based on information and belief formed after reasonable inquiry, the statements and <br /> information provided in this document are true, accurate, and complete. <br /> Signature of Technician: wl <br /> **NOTE: For EVR systems—Prior to the Leak Decay Test,if the liquid drained from the hose is<25 ml,record the amount in the EVR short version column,mark the <br /> test as pass,and no further testing is required. <br /> Ver. 1.5—08.20.14 <br />