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FACILITY PARAMETERS GDF Name and addresss GDF Representative and Title _________________________________ PHASE II SYSTEM TYPE (Check One) Balance ____ Hirt ____ Red Jacket ____ Hasstech ____ Healy ____Other GDF Phone No. (___)________________ Permit Conditions Source: GDF Vapor Recovery System GDF # A/C # Manifolded? Y or N Operating Parameters Number of Nozzles Served by Tank #1 ______ Number of Nozzles Served by Tank #3 ______ Number of Nozzles Served by Tank #2 ______ Number of Nozzles Served by Tank #4 ______ Applicable Regulations: VN Recommended Source Test Results and Comments Tank #: 1.Product Grade 2.Actual Tank Capacity, gallons 3.Gasoline Volume 4.Ullage, gallons (#2-#3) 5.Initial Pressure, inches H 2 O 6.Pressure After 1 Minute, inches H 2 O 7.Pressure After 2 Minutes, inches H 2 O 8.Pressure After 3 Minutes, inches H 2 O 9.Pressure After 4 Minutes, inches H 2 O 10.Final Pressure After 5 Minutes, inches H 2 O 11.Allowable Final Pressure Test Conducted by: Test Company: Date of Test: California Air Resources Board July 26, 2012 TP-201.3, Page 14 40CFR63CCCCCC Precision Testing Technologies Maverik #378 2036 w Pioneer rd Slaterville, UT 4 4 4 NA 1 Reg 11594 6528 3906 2.0 1.90 1.80 1.70 1.60 1.50 1.63 2 Reg 2 11594 6508 3926 2.0 2.0 2.0 1.99 1.99 1.99 1.63 3 Prm 11594 6814 3620 2.0 2.0 2.0 2.0 2.0 2.0 1.62 4 Clr 11594 4566 5868 2.0 1.50 1.00 0.50 0.00 0.00 1.74 Saxon Usher UT-420 10/23/2024 Maverik #378 2036 w Pioneer rd California Air Resources Board October 8, 2003 TP-201.1B, Page 5 Form 1 Static Torque of Rotatable Phase I Adaptors Measurement Units: (Check Box): pound-inches pound-feet Vapor Adaptor 1 Vapor Adaptor 2 Vapor Adaptor 3 Vapor Adaptor 4 Brand:Brand:Brand:Brand: Model:Model:Model:Model: Grade:Grade:Grade:Grade: Torque 1:Torque 1:Torque 1:Torque 1: Torque 2:Torque 2:Torque 2:Torque 2: Torque 3:Torque 3:Torque 3:Torque 3: Average:Average:Average:Average: 360 Rotation:360 Rotation: 360 Rotation:360 Rotation: Product Adaptor 1 Product Adaptor 2 Product Adaptor 3 Product Adaptor 4 Brand:Brand:Brand:Brand: Model:Model:Model:Model: Grade:Grade:Grade:Grade: Torque 1:Torque 1:Torque 1:Torque 1: Torque 2:Torque 2:Torque 2:Torque 2: Torque 3:Torque 3:Torque 3:Torque 3: Average:Average:Average:Average: 360 Rotation: 360 Rotation: 360 Rotation:360 Rotation: Comments: ___________________________________________________________________ Test Company:Conducted By: Test Date:Facility Name: Facility Address:City: Precision Testing Technologies Saxon Usher UT-420 10/23/2024 Maverik #378 Slaterville, UT 4 OPW 61VSA Reg 90 90 90 90 Yes OPW 61SA Reg 90 90 90 90 Yes OPW 61VSA Reg 2 100 100 100 100 Yes OPW 61SA Reg 2 85 85 85 85 Yes OPW 61VSA Prm 100 100 100 100 Yes OPW 61SA Prm 80 80 80 80 Yes OPW 61VSA Clr 98 98 98 98 Yes OPW 61SA Clr 70 70 70 70 Yes Pressure/Vacuum (P/V) Vent Valve Data Sheet Facility Name: Test Date: Address: Test Company: Precision Testing Technologies City: Tester Name: Product: P/V Valve Manufacturer: Model Number: Pass Fail Manufacturers Specified Positive Leak Rate (CFH): Manufacturers Specified Negative Leak Rate (CFH): Measured Positive Leak Rate (CFH): Measured Negative Leak Rate (CFH): Positive Cracking Pressure (in H2O): Negative Cracking Pressure (in H2O): Product: P/V Valve Manufacturer: Model Number: Pass Fail Manufacturers Specified Positive Leak Rate (CFH): Manufacturers Specified Negative Leak Rate (CFH): Measured Positive Leak Rate (CFH): Measured Negative Leak Rate (CFH): Positive Cracking Pressure (in H2O): Negative Cracking Pressure (in H2O): Product: P/V Valve Manufacturer: Model Number: Pass Fail Manufacturers Specified Positive Leak Rate (CFH): Manufacturers Specified Negative Leak Rate (CFH): Measured Positive Leak Rate (CFH): Measured Negative Leak Rate (CFH): Positive Cracking Pressure (in H2O): Negative Cracking Pressure (in H2O): Product: P/V Valve Manufacturer: Model Number: Pass Fail Manufacturers Specified Positive Leak Rate (CFH): Manufacturers Specified Negative Leak Rate (CFH): Measured Positive Leak Rate (CFH): Measured Negative Leak Rate (CFH): Positive Cracking Pressure (in H2O): Negative Cracking Pressure (in H2O): 2.5" to 6" wc <=0.05 cfh @ 2" wc 2.5" to 6" wc <=0.05 cfh @2" wc 2.5" to 6" wc <=0.05 cfh 2" wc 2.5" to 6" wc <=0.05 cfh 2" wc 6" to 10" wc <=0.21 cfh @ 4" wc 6" to 10" wc <=0.21 cfh @ 4" wc 6" to 10" wc <=0.21 cfh @ 4" wc 6" to 10" wc <=0.21 cfh @ 4" wc Maverik #378 10/23/2024 Saxon Usher UT-420 Reg OPW 623V 4 0.02@2"wc 3"wc 0.12@4"wc 7"wc Prm OPW 623V 4 0.04@2"wc 5"wc 0.18@4"wc 8"wc Clr OPW 623V 4 Maverik #378 Saxon Usher UT-420 10/23/2024