Spill Bucket

PEI/RP1200-19

APPENDIX C-10

SHEAR VALVE OPERATION INSPECTION

Facility Name:

Sirmola Agency

Owner:

Westonik web solution

Address:

3902/A New Street, Sirmola North korea

Address:

City, State, Zip Code:

Ketchikan, Alaska, 99950

City, State, Zip Code:

, , 46554

Facility I.D. #:

Test2

Phone #:

219-210-0622

Testing Company:

Midwest Ecs LLC

Phone #:

219-210-0052

This data sheet is for inspecting shear valves located inside dispensers. See PEI/RP1200 Section 10 for the inspection procedure.

Product Grade

ertyu

ctvyb

Dispenser ID#

ghbj

ghjj

Shear ValveType (Product/Vapor)

gvhbj

gcvhbj

1. Is the shear valve rigidly
anchored to the dispenser box
frame or dispenser island?

Yes

✔

Yes

2. Is the shear section posi
tioned between ½ inch above
or below the top surface of the
dispenser island?

✔

Yes

✔

Yes

3. Is the lever arm free to move?

Yes

✔

Yes

✔

4. Does the lever arm snap shut
the poppet valve?

Yes

✔

Yes

✔

5. Can any product be dispensed
when the product shear valve is
closed?

Yes

✔

Yes

✔

A “No” to Lines 1-4 or a “Yes” for Line 5 indicates a test failure.

Test Results

✔

Pass

Fail

✔

Pass

Fail

Comments:

gvhbknnjklbiu ubv b jbk n

Tester's Name (print)

Tester's Signature

APPENDIX C-10

SHEAR VALVE OPERATION INSPECTION

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