Dr Carl H.D. Steinmetz Amsterdam The Netherlands WRIC, Brussels 5 and 6 June 2013.
Virginia Department of Agriculture and Consumer Services...
Transcript of Virginia Department of Agriculture and Consumer Services...
Virginia Department of Agricultureand Consumer Services
Office of Weights and Measures102 Governor Street
Richmond, Virginia 23219(804) 786-2476
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/9/2010 Business ID: 00163065 Inspection: AU000519Business: WOODFIN WATCHARD Store #:
4511 POUNCY TRACT RD Phone: (804)355-7104Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 4 4
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM 785-2-rc-tw-apc 64858 Bio-Diesel (B6-B9 1 0 Approved 5.000TOKHEIM 785-2-rc-tw-apc 64858 Off Road Diesel 2 0 Approved 5.000TOKHEIM 785-2-rc-tw-apc 64864 87 3 0 Approved 5.000TOKHEIM 785-2-rc-tw-apc 64864 87 4 0 Approved 5.000TOKHEIM 785-2-rc-tw-apc 64859 Diesel 5 0 Approved 5.000TOKHEIM 785-2-rc-tw-apc 64859 Diesel 6 0 Approved 5.000
Device Product Used: 30. Insp Product Used: . Tot Product Used: 30.Grade Prod Used87 10.00Bio-Diesel (B6 5.00
Page 1 of 466
Inspector Acknowledged Receipt: ROY BOMAR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Diesel 10.00Off Road Dies 5.00
Billing Address:
,
Notes:
Page 2 of 466
Inspector Acknowledged Receipt: ROY BOMAR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/9/2010 Business ID: 00163059 Inspection: AU000520Business: QUARLES WATCHCARD Store #:
8410 BROOK RD Phone: -877-444-3835Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 10 9 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GASBOY 9153AXTW1C 460850 87 1 0 Approved 5.000GASBOY 9153AXTW1C 460850 87 2 0 Approved 5.000GASBOY 9153AXTW1C 450839 Off Road Diesel 3 0 Approved 5.000GASBOY 9152ATXW1 C 460843 93 4 0 Approved 10.000GASBOY 9153ATW1-CX 460843 93 5 0 Approved 10.000GASBOY 9153ATW1-CX 460851 89 6 0 Approved 5.000GASBOY 9153ATW1-CX 469846 87 7 0 Approved 5.000GASBOY 9153AXTW1C 460840 87 8 16 Condemned 5.000GASBOY 9153AXTW1C 460840 Diesel 9 0 Approved 5.000GASBOY 9153AXTW1C 460841 Diesel 10 0 Approved 5.000
Device Product Used: 60. Insp Product Used: . Tot Product Used: 60.Grade Prod Used87 20.0089 5.0093 20.00Diesel 10.00Off Road Dies 5.00
Billing Address:
Page 3 of 466
Inspector Acknowledged Receipt: ROY BOMAR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Page 4 of 466
Inspector Acknowledged Receipt: ROY BOMAR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 5 of 466
Inspector Acknowledged Receipt: ROY BOMAR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/9/2010 Business ID: 00163047 Inspection: AU000521Business: WOODFIN WATCHCARD Store #:
4901 WILLIAMSBURG RD Phone: (804)730-4500Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 7 6 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GASBOY 9152AXTW2 C MNG0008197-1 87 1 0 Approved 5.000GASBOY 9152ATXW1 C MNGOOO8197-2 87 2 0 Approved 5.000GASBOY 785RCPR 01978553278 Off Road Diesel 3 0 Approved 5.000GASBOY 9152ATXW1 C MNGOO3198-4 87 4 0 Approved 5.000GASBOY 9152ATXW1 C MN0003198-5 87 5 0 Approved 5.000GASBOY 9153ATW1-CX 501362 Diesel 6 0 Approved 5.000GASBOY 9153ATW1-CX MNG0001941 Diesel 7 10 Rejected 5.000GASBOY 9153ATW1-CX 501362 Diesel 8 0 Approved 5.000
Device Product Used: 40. Insp Product Used: . Tot Product Used: 40.Grade Prod Used87 20.00Diesel 15.00Off Road Dies 5.00
Billing Address:
,
Page 6 of 466
Inspector Acknowledged Receipt: ROY BOMAR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Page 7 of 466
Inspector Acknowledged Receipt: ROY BOMAR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 8 of 466
Inspector Acknowledged Receipt: ROY BOMAR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/17/2010 Business ID: 00162364 Inspection: AU000553Business: QUARLES Q CARD Store #:
6050 AUDUBON DR Phone: (540)371-2400Inspector: 325 MIKE TILLMAN
SANDSTON, VA 23150 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 6 6
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GASBOY 9152RDXC 430377-1 Diesel 1 0 Approved 5.000GASBOY 9152RDXC 430384-2 92 2 0 Approved 5.000GASBOY 9152RDXC 444576-3 87 3 0 Approved 5.000GASBOY 9152RDXC 444576-4 87 4 0 Approved 5.000GASBOY 9153RDX2 444578-5 Diesel 5 0 Approved 5.000GASBOY 9153RDX2 4444578-6 Diesel 6 0 Approved 5.000
Device Product Used: 30. Insp Product Used: . Tot Product Used: 30.Grade Prod Used87 10.0092 5.00Diesel 15.00
Billing Address:
,
Notes:
Page 9 of 466
Inspector Acknowledged Receipt: JAY FINES
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/18/2010 Business ID: 00021473 Inspection: AU000555Business: FAST STOP 1 Store #:
2301 MECHANICSVILLE TNPK Phone: (804)782-9326Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 4 4
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B05 PAO37481-1 89 1 -1 Approved 1.000GILBARCO B05 PA037478-12 89 12 -1 Approved 1.000GILBARCO B05 PA037483-5 Diesel 5 0 Approved 0.000GILBARCO AC4921A 92516-13 Kerosene 0 Approved 0.000
Device Product Used: 2. Insp Product Used: . Tot Product Used: 2.Grade Prod Used89 2.00
Billing Address:
,
Notes:
Page 10 of 466
Inspector Acknowledged Receipt: AHAF LADHANI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/23/2010 Business ID: 00163583 Inspection: AU000561Business: NORTH PARK SHELL Store #: #10
805 PARHAM RD Phone: 804-266-4407Inspector: 325 MIKE TILLMAN
RICHM0ND, VA 23227 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B78 PA141847-5 87 5 0 Approved 5.000 C-7087
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
no problem found
Page 11 of 466
Inspector Acknowledged Receipt: NIDA MUNIR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/26/2010 Business ID: 00163059 Inspection: AU000581Business: QUARLES WATCHCARD Store #:
8410 BROOK RD Phone: -877-444-3835Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GASBOY 9153AXTW1C 460840 87 8 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 12 of 466
Inspector Acknowledged Receipt: ROY BOMAR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/26/2010 Business ID: 00163047 Inspection: AU000582Business: WOODFIN WATCHCARD Store #:
4901 WILLIAMSBURG RD Phone: (804)730-4500Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GASBOY 9153ATW1-CX MNG0001941 Diesel 7 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod UsedDiesel 5.00
Billing Address:
,
Notes:
Page 13 of 466
Inspector Acknowledged Receipt: ROY BOMAR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/31/2010 Business ID: 00021386 Inspection: AU000595Business: REGENCY SHELL /SMO Store #:
1501 N PARHAM RD Phone: (804)282-4470Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 2 2
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B87 PA211618-3 Diesel 3 0 Approved 5.000GILBARCO B87 PA211618-4 Diesel 4 -3 Approved 5.000
Device Product Used: 10. Insp Product Used: . Tot Product Used: 10.Grade Prod UsedDiesel 10.00
Billing Address:
,
Notes:
Page 14 of 466
Inspector Acknowledged Receipt: SAIFUL ISLAM
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/31/2010 Business ID: 00111766 Inspection: AU000596Business: WORLD MINI MARKET Store #: #664
9015 QUIOCCASIN RD Phone: (804-781-6905Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 3 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B70 PA120845-1 87 1 0 Approved 5.000GILBARCO B70 PA120845-1 89 1 0 Approved 5.000GILBARCO B70 PA120845-1 93 1 0 Approved 5.000
Device Product Used: 15. Insp Product Used: . Tot Product Used: 15.Grade Prod Used87 5.0089 5.0093 5.00
Billing Address:
,
Notes:
Page 15 of 466
Inspector Acknowledged Receipt: YANA PONOMARENKO
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/31/2010 Business ID: 00112066 Inspection: AU000598Business: MILLER MART BP Store #:
11520 W BROAD ST Phone: (804)364-2495Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H426B- 032515-1 87 1 0 Approved 0.000
Billing Address:
,
Notes:
Page 16 of 466
Inspector Acknowledged Receipt: VIJAY SHAH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/31/2010 Business ID: 00113721 Inspection: AU000599Business: FAS MART Store #: #12
4690 POUNCY TRACT RD Phone: (804)364-2977Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE X1/V590D4/GJ 717233-9 93 9 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used93 5.00
Billing Address:
,
Notes:
Page 17 of 466
Inspector Acknowledged Receipt: RICHARD FERRAMOSCA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/31/2010 Business ID: 00163076 Inspection: AU000600Business: EXXON WEST END Store #: #28407
9525 W BROAD ST Phone: (804)615-5102Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 6 6
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO AK1220 700076-2 87 2 0 Approved 0.000GILBARCO AK1220 700076-2 89 2 0 Approved 0.000GILBARCO AK1220 700076-2 93 2 0 Approved 0.000GILBARCO AK1220 CA014202-5 87 5 0 Approved 0.000GILBARCO AK1220 CA014202-5 89 5 0 Approved 0.000GILBARCO AK1220 CA014202-5 93 5 0 Approved 0.000
Billing Address:
,
Notes:
Page 18 of 466
Inspector Acknowledged Receipt: JAGDEEP SINGH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/31/2010 Business ID: 00238899 Inspection: AU000601Business: INNSBROOK EXXON Store #:
4101 DOMINION BLVD Phone: 804-290-4449Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 FMEN032051-8 93 8 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used93 5.00
Billing Address:
,
Notes:
Page 19 of 466
Inspector Acknowledged Receipt: CUTRGHT CHERYL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/5/2010 Business ID: 00112066 Inspection: AU000602Business: MILLER MART BP Store #:
11520 W BROAD ST Phone: (804)364-2495Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 4 3 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H426B- 032515-1 89 1 0 Approved 0.000TOKHEIM H426B- 032515-2 89 2 0 Approved 0.000TOKHEIM H426B- 032486-7 89 7 0 Condemned 0.000TOKHEIM H426B- 032486-8 89 8 0 Approved 0.000
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are
Page 20 of 466
Inspector Acknowledged Receipt: PAUL ANGADIADH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 21 of 466
Inspector Acknowledged Receipt: PAUL ANGADIADH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/5/2010 Business ID: 00111983 Inspection: AU000603Business: TUCKAHOE BP Store #:
11310 PATTERSON AVE Phone: (804)740-5748Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Placed into Service
Class Actv App Rej Con CwC NTLiquid Measuring Device 15 10 2 3Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 DTEN 146611-1 87 1 18 Condemned 5.000GILBARCO NN1 DTEN 146611-1 89 1 12 Condemned 5.000GILBARCO NN1 DTEN 146611-1 93 1 2 Approved 5.000GILBARCO NN1 DTEN146611-2 87 2 0 Approved 5.000GILBARCO NN1 DTEN146611-2 89 2 0 Approved 5.000 GILBARCO NN1 DTEN146611-2 93 2 2 Approved 5.000GILBARCO NN1 DTEN146609 87 3 0 Approved 5.000GILBARCO NN1 DTEN146609 89 3 0 Approved 5.000GILBARCO NN1 DTEN146609 93 3 0 Approved 5.000GILBARCO NN1 DTEN146609-4 87 4 0 Approved 5.000GILBARCO NN1 DTEN146609-4 89 4 0 Approved 5.000GILBARCO NN1 DTEN146609-4 93 4 0 Approved 5.000GILBARCO NN1 DTEN146610 87 5 0 Approved 5.000GILBARCO NN1 DTEN146610 89 5 0 Approved 5.000GILBARCO NN1 DTEN146610 93 5 0 Approved 5.000GILBARCO NN1 DTEN146610-6 87 6 0 Approved 5.000GILBARCO NN1 DTEN146610-6 89 6 0 Approved 5.000GILBARCO NN1 DTEN146610-6 93 6 0 Approved 5.000GILBARCO NN1 DTEN146608 87 7 0 Not Tested 0.000GILBARCO NN1 DTEN146608 89 7 0 Not Tested 0.000
Page 22 of 466
Inspector Acknowledged Receipt: STACY MCCAULEY
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 DTEN146608 93 7 0 Not Tested 0.000GILBARCO NN1 DTEN146608-8 87 8 9 Rejected 5.000GILBARCO NN1 DTEN146608-8 89 8 5 Approved 5.000GILBARCO NN1 DTEN146608-8 93 8 0 Approved 5.000
Device Product Used: 105. Insp Product Used: . Tot Product Used: 105.Grade Prod Used87 35.0089 35.0093 35.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service
Page 23 of 466
Inspector Acknowledged Receipt: STACY MCCAULEY
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 24 of 466
Inspector Acknowledged Receipt: STACY MCCAULEY
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/5/2010 Business ID: 00111990 Inspection: AU000604Business: SEIBERTS PUMP & CHURCH BP Store #: #111
11902 CHURCH RD Phone: (804)360-3151Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Placed into Service
Class Actv App Rej Con CwC NTLiquid Measuring Device 12 12Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NGO 177119 87 1 0 Approved 5.000GILBARCO NGO 177119 89 1 0 Approved 5.000GILBARCO NGO 177119 93 1 0 Approved 5.000GILBARCO NGO 177119-2 87 2 0 Approved 5.000GILBARCO NGO 177119-2 89 2 0 Approved 5.000GILBARCO NGO 177119-2 93 2 0 Approved 5.000GILBARCO NGO 177118 87 3 0 Approved 5.000GILBARCO NGO 177118 89 3 0 Approved 5.000GILBARCO NGO 177118 93 3 0 Approved 5.000GILBARCO NGO 177118-4 87 4 0 Approved 5.000GILBARCO NGO 177118-4 89 4 0 Approved 5.000GILBARCO NGO 177118-4 93 4 0 Approved 5.000GILBARCO NGO 177117 87 5 0 Approved 5.000GILBARCO NGO 177117 89 5 0 Approved 5.000GILBARCO NGO 177117 93 5 0 Approved 5.000GILBARCO NGO 177117-6 87 6 0 Approved 5.000GILBARCO NGO 177117-6 89 6 0 Approved 5.000GILBARCO NGO 177117-6 93 6 0 Approved 5.000GILBARCO NGO 177120 87 7 0 Approved 5.000GILBARCO NGO 177120 89 7 0 Approved 5.000
Page 25 of 466
Inspector Acknowledged Receipt: JOANN GODSEY
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NGO 177120 93 7 0 Approved 5.000GILBARCO NGO 177120-8 87 8 0 Approved 5.000GILBARCO NGO 177120-8 89 8 0 Approved 5.000GILBARCO NGO 177120-8 93 8 0 Approved 5.000
Device Product Used: 120. Insp Product Used: . Tot Product Used: 120.Grade Prod Used87 40.0089 40.0093 40.00
Billing Address:
,
Notes:
Page 26 of 466
Inspector Acknowledged Receipt: JOANN GODSEY
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/5/2010 Business ID: 00021677 Inspection: AU000605Business: LUCKYS CONVENIENCE STORE Store #:
2800 PUMP RD Phone: 804-360-4480Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 24 24Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO V590D1/GQY 679387-1 87 1 -2 Approved 5.000GILBARCO V590D1/GQY 679387-1 89 1 0 Approved 5.000GILBARCO V590D1/GQY 679387-1 93 1 0 Approved 5.000GILBARCO V590D1/GQY 679387-2 87 2 0 Approved 5.000GILBARCO V590D1/GQY 679387-2 89 2 0 Approved 5.000GILBARCO V590D1/GQY 679387-2 93 2 0 Approved 5.000GILBARCO V590D1/GQY 679389-3 87 3 0 Approved 5.000GILBARCO V590D1/GQY 679389-3 89 3 0 Approved 5.000GILBARCO V590D1/GQY 679389-3 93 3 0 Approved 5.000GILBARCO V590D1/GQY 670389-4 87 4 1 Approved 5.000GILBARCO V590D1/GQY 670389-4 89 4 2 Approved 5.000GILBARCO V590D1/GQY 670389-4 93 4 0 Approved 5.000GILBARCO V590D1/GQY 679391-5 87 5 5 Approved 5.000GILBARCO V590D1/GQY 679391-5 89 5 0 Approved 5.000GILBARCO V590D1/GQY 679391-5 93 5 2 Approved 5.000GILBARCO V590D1/GQY 679391-6 87 6 2 Approved 5.000GILBARCO V590D1/GQY 679391-6 89 6 2 Approved 5.000GILBARCO V590D1/GQY 679391-6 93 6 2 Approved 5.000GILBARCO V590D1/GQY 679390-7 87 7 4 Approved 5.000GILBARCO V590D1/GQY 679390-7 89 7 6 Approved 5.000
Page 27 of 466
Inspector Acknowledged Receipt: M.D. AYUB
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO V590D1/GQY 679390-7 93 7 2 Approved 5.000GILBARCO V590D1/GQY 679390-8 87 8 0 Approved 5.000GILBARCO V590D1/GQY 679390-8 89 8 0 Approved 5.000GILBARCO V590D1/GQY 679390-8 93 8 -6 Approved 5.000
Device Product Used: 120. Insp Product Used: . Tot Product Used: 120.Grade Prod Used87 40.0089 40.0093 40.00
Billing Address:
,
Notes:
Page 28 of 466
Inspector Acknowledged Receipt: M.D. AYUB
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/6/2010 Business ID: 00110576 Inspection: AU000606Business: ROYAL MART SHELL Store #:
1113 E NINE MILE RD Phone: (804)737-5688Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23075 Reason: Placed into Service
Class Actv App Rej Con CwC NTLiquid Measuring Device 42 36 6Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NGO LUEN177643-1 87 1 0 Approved 5.000GILBARCO NGO LUEN177643-1 89 1 0 Approved 5.000GILBARCO NGO LUEN177643-1 93 1 0 Approved 5.000GILBARCO NGO LUEN177643-2 87 2 0 Approved 5.000GILBARCO NGO LUEN177643-2 89 2 0 Approved 5.000GILBARCO NGO LUEN177643-2 93 2 0 Approved 5.000GILBARCO NG1 LUEN177705-3 87 3 0 Approved 5.000GILBARCO NG1 LUEN177705-3 89 3 0 Approved 5.000GILBARCO NG1 LUEN177705-3 93 3 0 Approved 5.000GILBARCO NG1 LUEN177705-3 Diesel 3 0 Rejected 5.000GILBARCO NG1 LUEN177705-4 87 4 0 Approved 5.000GILBARCO NG1 LUEN177705-4 89 4 0 Approved 5.000GILBARCO NG1 LUEN177705-4 93 4 0 Approved 5.000GILBARCO NG1 LUEN177705-4 Diesel 4 0 Rejected 5.000GILBARCO NGO LUEN177644-5 87 5 0 Approved 5.000GILBARCO NGO LUEN177644-5 89 5 0 Approved 5.000GILBARCO NGO LUEN177644-5 93 5 0 Approved 5.000GILBARCO NGO LUEN177644-6 87 6 0 Approved 5.000GILBARCO NGO LUEN177644-6 89 6 0 Approved 5.000GILBARCO NGO LUEN177644-6 93 6 0 Approved 5.000
Page 29 of 466
Inspector Acknowledged Receipt: BYRON WOOLRDGE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NG1 LUEN177623-7 87 7 0 Approved 5.000GILBARCO NG1 LUEN177623-7 89 7 0 Approved 5.000GILBARCO NG1 LUEN177623-7 93 7 0 Approved 5.000GILBARCO NG1 LUEN177623-7 Diesel 7 0 Rejected 5.000GILBARCO NG1 LUEN177623-8 87 8 0 Approved 5.000GILBARCO NG1 LUEN177623-8 89 8 0 Approved 5.000GILBARCO NG1 LUEN177623-8 93 8 0 Approved 5.000GILBARCO NG1 LUEN177623-8 Diesel 8 0 Rejected 5.000GILBARCO NGO LUEN177642-9 87 9 0 Approved 5.000GILBARCO NGO LUEN177642-9 89 9 0 Approved 5.000GILBARCO NGO LUEN177642-9 93 9 0 Approved 5.000GILBARCO NGO LUEN177642-10 87 10 0 Approved 5.000GILBARCO NGO LUEN177642-10 89 10 0 Approved 5.000GILBARCO NGO LUEN177642-10 93 10 0 Approved 5.000GILBARCO NG1 LUEN176839-11 87 11 0 Approved 5.000GILBARCO NG1 LUEN176839-11 89 11 0 Approved 5.000GILBARCO NG1 LUEN176839-11 93 11 0 Approved 5.000GILBARCO NG1 LUEN176839-11 Diesel 11 0 Rejected 5.000GILBARCO NG1 LUEN176839-12 87 12 0 Approved 5.000GILBARCO NG1 LUEN176839-12 89 12 0 Approved 5.000GILBARCO NG1 LUEN176839-12 93 12 0 Approved 5.000GILBARCO NG1 LUEN176839-12 Diesel 12 0 Rejected 5.000
Device Product Used: 210. Insp Product Used: . Tot Product Used: 210.Grade Prod Used87 60.0089 60.0093 60.00Diesel 30.00
Billing Address:
,
Page 30 of 466
Inspector Acknowledged Receipt: BYRON WOOLRDGE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Page 31 of 466
Inspector Acknowledged Receipt: BYRON WOOLRDGE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 32 of 466
Inspector Acknowledged Receipt: BYRON WOOLRDGE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/6/2010 Business ID: 00161717 Inspection: AU000607Business: AIRPORT EXXON UPPYS # 40 Store #: #26558
4710 WILLIAMSBURG RD Phone: 804-236-0021Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 2 2
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 BSEN121601-1 87 1 3 Approved 5.000
GILBARCO NN1 BSEN121601-2 87 2 5 Approved 5.000C-8011NO PROBLEM FOUND
Device Product Used: 10. Insp Product Used: . Tot Product Used: 10.Grade Prod Used87 10.00
Billing Address:
,
Notes:
Page 33 of 466
Inspector Acknowledged Receipt: REGINA BRUCE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/7/2010 Business ID: 00163589 Inspection: AU000608Business: ROYAL MART Store #: #7
8920 W BROAD ST Phone: (804)346-9293Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Placed into Service
Class Actv App Rej Con CwC NTLiquid Measuring Device 28 28Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NG1 177624-5 87 5 0 Approved 5.000GILBARCO NG1 177624-5 89 5 0 Approved 5.000GILBARCO NG1 177624-5 93 5 0 Approved 5.000GILBARCO NG1 177624-5 Diesel 5 0 Approved 5.000GILBARCO NG1 177624-6 87 6 0 Approved 5.000GILBARCO NG1 177624-6 89 6 0 Approved 5.000GILBARCO NG1 177624-6 93 6 0 Approved 5.000GILBARCO NG1 177624-6 Diesel 6 0 Approved 5.000GILBARCO NG1 192261-3 87 3 0 Approved 5.000GILBARCO NG1 192261-3 89 3 0 Approved 5.000GILBARCO NG1 192261-3 93 3 0 Approved 5.000GILBARCO NG1 192261-3 Diesel 3 0 Approved 5.000GILBARCO NG1 192261-4 87 4 0 Approved 5.000GILBARCO NG1 192261-4 89 4 0 Approved 5.000GILBARCO NG1 192261-4 93 4 0 Approved 5.000GILBARCO NG1 192261-4 Diesel 4 0 Approved 5.000GILBARCO NGO 177621-7 87 3 0 Approved 5.000GILBARCO NGO 177621-7 89 3 0 Approved 5.000GILBARCO NGO 177621-7 93 3 0 Approved 5.000GILBARCO NGO 177621-8 87 4 0 Approved 5.000
Page 34 of 466
Inspector Acknowledged Receipt: CLIFF ALEXANDER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NGO 177621-8 89 4 0 Approved 5.000GILBARCO NGO 177621-8 93 4 0 Approved 5.000GILBARCO NGO 177622-1 87 1 0 Approved 5.000GILBARCO NGO 177622-1 89 1 0 Approved 5.000GILBARCO NGO 177622-1 93 1 0 Approved 5.000GILBARCO NGO 177622-2 87 2 0 Approved 5.000GILBARCO NGO 177622-2 89 2 0 Approved 5.000GILBARCO NGO 177622-2 93 2 0 Approved 5.000
Device Product Used: 140. Insp Product Used: . Tot Product Used: 140.Grade Prod Used87 40.0089 40.0093 40.00Diesel 20.00
Billing Address:
,
Notes:
Page 35 of 466
Inspector Acknowledged Receipt: CLIFF ALEXANDER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/7/2010 Business ID: 00500740 Inspection: AU000610Business: 7 - EIEVEN #34015 Store #: #34015
9500 W. BROAD ST Phone: 804-270-4345Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23294 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 5 2 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 KTEN156044-1 93 1 11 Condemned 5.000GILBARCO NN1 KTEN156042-5 89 5 6 Approved 5.000GILBARCO NN1 KTEN156042-5 93 5 12 Condemned 5.000GILBARCO NN1 KTEN156042-6 89 6 6 Approved 5.000GILBARCO NN1 KTEN156042-6 93 6 11 Condemned 5.000
Device Product Used: 25. Insp Product Used: . Tot Product Used: 25.Grade Prod Used89 10.0093 15.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 36 of 466
Inspector Acknowledged Receipt: SHAHANAJ JABIN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 37 of 466
Inspector Acknowledged Receipt: SHAHANAJ JABIN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/7/2010 Business ID: 00113953 Inspection: AU000611Business: 7-ELEVEN Store #: #32396
4051 COX ROAD Phone: 804-747-7512Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 4 3 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA224922-9 87 9 0 Condemned 2.000 NOT WORKINGGILBARCO B79 PA224924-11 87 11 6 Approved 5.000GILBARCO B79 PA224924-11 89 11 6 Approved 5.000GILBARCO B79 PA224924-11 93 11 6 Approved 5.000
Device Product Used: 17. Insp Product Used: . Tot Product Used: 17.Grade Prod Used87 7.0089 5.0093 5.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 38 of 466
Inspector Acknowledged Receipt: FAUZIA RAHMAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 39 of 466
Inspector Acknowledged Receipt: FAUZIA RAHMAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/9/2010 Business ID: 00111753 Inspection: AU000617Business: ZOTAS # 659 CITGO Store #: #659
501 S AIRPORT RD Phone: (804)328-5170Inspector: 325 MIKE TILLMAN
SANDSTON, VA 23150 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO N/A 5190-3 87 3 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 40 of 466
Inspector Acknowledged Receipt: HAWI KEJELA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/9/2010 Business ID: 00110576 Inspection: AU000618Business: ROYAL MART SHELL Store #:
1113 E NINE MILE RD Phone: (804)737-5688Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23075 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 6 6
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NG1 LUEN177705-3 Diesel 3 0 Approved 0.000GILBARCO NG1 LUEN177705-4 Diesel 4 0 Approved 0.000GILBARCO NG1 LUEN177623-7 Diesel 7 0 Approved 0.000GILBARCO NG1 LUEN177623-8 Diesel 8 0 Approved 0.000GILBARCO NG1 LUEN176839-11 Diesel 11 0 Approved 0.000GILBARCO NG1 LUEN176839-12 Diesel 12 0 Approved 0.000
Billing Address:
,
Notes:
Page 41 of 466
Inspector Acknowledged Receipt: BYRON WOOLRIDGE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/16/2010 Business ID: 00114004 Inspection: AU000624Business: 7-ELEVEN Store #: #23883
9085 WOODMAN RD Phone: (757)490-6338Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B05 PA006112-3 87 3 0 Condemned 1.000
Device Product Used: 1. Insp Product Used: . Tot Product Used: 1.Grade Prod Used87 1.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
Page 42 of 466
Inspector Acknowledged Receipt:
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 43 of 466
Inspector Acknowledged Receipt:
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/16/2010 Business ID: 00111765 Inspection: AU000625Business: ZOTAS CITGO Store #: #662
7834 PARHAM RD Phone: (804)747-6090Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 5 2 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA094305-5 87 5 -1 Condemned 1.000GILBARCO B79 PA094305-5 89 5 0 Condemned 0.000GILBARCO B79 PA094305-5 93 5 0 Condemned 0.000GILBARCO B79 PA094305-6 87 6 0 Approved 0.000GILBARCO B79 PA094305-6 89 6 0 Approved 0.000
Device Product Used: 1. Insp Product Used: . Tot Product Used: 1.Grade Prod Used87 1.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 44 of 466
Inspector Acknowledged Receipt: SYFUL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 45 of 466
Inspector Acknowledged Receipt: SYFUL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/16/2010 Business ID: 00248860 Inspection: AU000626Business: WAWA Store #: #8603
8017 W BROAD STREET Phone: (804)290-4374Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23294 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 3 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 MPEN085121-15 87 15 0 Approved 0.000GILBARCO NN1 MPEN085121-15 89 15 0 Approved 0.000GILBARCO NN1 MPEN085121-15 93 15 0 Approved 0.000
Billing Address:
,
Notes:
Page 46 of 466
Inspector Acknowledged Receipt: SCOTT PEARSON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/16/2010 Business ID: 00111760 Inspection: AU000627Business: ZOTAS / RENNIES SHELL Store #: #652
8600 PATTERSON AVE Phone: (804741-1091Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 2 2
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B05 PA020960-5 87 5 -1 Approved 1.000GILBARCO B05 PA020960-6 87 6 -1 Approved 1.000
Device Product Used: 2. Insp Product Used: . Tot Product Used: 2.Grade Prod Used87 2.00
Billing Address:
,
Notes:
Page 47 of 466
Inspector Acknowledged Receipt: ALI RAFAQAT
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/16/2010 Business ID: 00021409 Inspection: AU000628Business: QUICK N EASY Store #:
10003 THREE CHOPT RD Phone: (804)747-0512Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 5 5
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B7C PA081122-1 93 1 0 Approved 5.000GILBARCO B7C PA081122-2 87 2 -1 Approved 1.000GILBARCO B7C PA081122-2 89 2 0 Approved 0.000GILBARCO B7C PA081122-2 93 2 0 Approved 0.000GILBARCO B7C PA081122-2 Diesel 2 0 Approved 0.000
Device Product Used: 6. Insp Product Used: . Tot Product Used: 6.Grade Prod Used87 1.0093 5.00
Billing Address:
,
Notes:
Page 48 of 466
Inspector Acknowledged Receipt: GORGE PATEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/16/2010 Business ID: 00112020 Inspection: AU000629Business: MILLER MART Store #: #67
11301 NUCKOLS RD Phone: 804-270-5061Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23059 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 6 6
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 EN016740-10 87 10 0 Approved 5.000GILBARCO NN1 EN016740-10 89 10 0 Approved 5.000GILBARCO NN1 EN016740-10 93 10 0 Approved 5.000GILBARCO NN1 EN016743-7 87 7 0 Approved 5.000GILBARCO NN1 EN016743-7 89 7 0 Approved 5.000GILBARCO NN1 EN016743-7 93 7 0 Approved 5.000
Device Product Used: 30. Insp Product Used: . Tot Product Used: 30.Grade Prod Used87 10.0089 10.0093 10.00
Billing Address:
,
Notes:
Page 49 of 466
Inspector Acknowledged Receipt: SHERYL BRUCE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/26/2010 Business ID: 00022105 Inspection: AU000632Business: FAIRFIELD BP Store #:
5051 NINE MILE RD Phone: (804)737-7611Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE DL335901LGO 602424-7 87 7 0 Approved 5.000 COMPLAINT#8051
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 50 of 466
Inspector Acknowledged Receipt: HARSHA PANCHASARA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/28/2010 Business ID: 00500737 Inspection: AU000633Business: UPPYS # 28 Store #: #28
3101 LAUDERDALE DR Phone: 804-360-0269Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 GSEN130312-4 87 4 0 Approved 10.000C-8059no problem found
Device Product Used: 10. Insp Product Used: . Tot Product Used: 10.Grade Prod Used87 10.00
Billing Address:
,
Notes:
Page 51 of 466
Inspector Acknowledged Receipt: SHANA HAMNER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/28/2010 Business ID: 00112066 Inspection: AU000634Business: MILLER MART BP Store #:
11520 W BROAD ST Phone: (804)364-2495Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H426B- 032486-7 89 7 0 Approved 0.000
Billing Address:
,
Notes:
Page 52 of 466
Inspector Acknowledged Receipt: VIJAY SHAH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/28/2010 Business ID: 00113953 Inspection: AU000635Business: 7-ELEVEN Store #: #32396
4051 COX ROAD Phone: 804-747-7512Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Reinspection 2
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA224922-9 87 9 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 53 of 466
Inspector Acknowledged Receipt: NAZNEEN SARWAR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 5/3/2010 Business ID: 00022207 Inspection: AU000637Business: SEIBERTS GASKINS SHELL Store #:
3830 GASKINS RD Phone: (804)346-3040Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 2 2
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NG1 MUEN176840-6 87 6 -1 Approved 1.000 C-8069GILBARCO NG1 MUEN176840-6 93 6 -1 Approved 1.000 C-8069
Device Product Used: 2. Insp Product Used: . Tot Product Used: 2.Grade Prod Used87 1.0093 1.00
Billing Address:
,
Notes:
Page 54 of 466
Inspector Acknowledged Receipt: STUART LINDER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 5/7/2010 Business ID: 00161972 Inspection: AU000649Business: CORNER MART Store #:
4050 SPRING OAK DR Phone: (804)364-4930Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 1/590D4/GQU 702303-7 87 7 3 Approved 5.000 C-8078
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 55 of 466
Inspector Acknowledged Receipt: ANGIE BROWN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 5/11/2010 Business ID: 00163374 Inspection: AU000652Business: POINTERS FOOD MART Store #:
400 W NINE MILE RD Phone: (804)328-1855Inspector: 325 MIKE TILLMAN
HIGHLAND SPRINGS, VA 23075 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 590D1/GQUY 681080-3 87 3 0 Approved 0.000NO PROMBLEM FOUND
Billing Address:
,
Notes:
Page 56 of 466
Inspector Acknowledged Receipt: ALICIA MOORE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 5/19/2010 Business ID: 00021386 Inspection: AU000669Business: REGENCY SHELL /SMO Store #:
1501 N PARHAM RD Phone: (804)282-4470Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B87 PA211618-4 87 4 3 Approved 5.000 C--8097
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 57 of 466
Inspector Acknowledged Receipt: SAI FUL ISLAM
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/14/2010 Business ID: 00193541 Inspection: AU000700Business: SHEETZ Store #: #350
7035 W BROAD STREET Phone: 804-755-6042Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23294 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 3 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO EN1 HMEC002347-16 87 16 0 Condemned 5.000GILBARCO EN1 HMEC002347-16 89 16 0 Condemned 0.000GILBARCO EN1 HMEC002347-16 93 16 0 Condemned 0.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
Page 58 of 466
Inspector Acknowledged Receipt: JUDY LACKS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 59 of 466
Inspector Acknowledged Receipt: JUDY LACKS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/14/2010 Business ID: 00113863 Inspection: AU000701Business: SAM'S CLUB Store #: #6343
9440 W BROAD ST Phone: 804-346-3031Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23294 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 3/D595D/G/D 44663-8 87 8 0 Approved 5.000 C-8140
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 60 of 466
Inspector Acknowledged Receipt: JOSH BELL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/14/2010 Business ID: 00500740 Inspection: AU000702Business: 7 - EIEVEN #34015 Store #: #34015
9500 W. BROAD ST Phone: 804-270-4345Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23294 Reason: Reinspection 2
Class Actv App Rej Con CwC NTLiquid Measuring Device 3 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 KTEN156044-1 93 1 0 Approved 5.000GILBARCO NN1 KTEN156042-5 93 5 0 Approved 5.000GILBARCO NN1 KTEN156042-6 93 6 0 Approved 5.000
Device Product Used: 15. Insp Product Used: . Tot Product Used: 15.Grade Prod Used93 15.00
Billing Address:
,
Notes:
Page 61 of 466
Inspector Acknowledged Receipt: SAIRIN NLN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/14/2010 Business ID: 00111765 Inspection: AU000703Business: ZOTAS CITGO Store #: #662
7834 PARHAM RD Phone: (804)747-6090Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Reinspection 2
Class Actv App Rej Con CwC NTLiquid Measuring Device 3 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA094305-5 87 5 0 Approved 0.000GILBARCO B79 PA094305-5 89 5 0 Approved 0.000GILBARCO B79 PA094305-5 93 5 0 Approved 0.000
Billing Address:
,
Notes:
Page 62 of 466
Inspector Acknowledged Receipt: SAIFUL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/14/2010 Business ID: 00114004 Inspection: AU000704Business: 7-ELEVEN Store #: #23883
9085 WOODMAN RD Phone: (757)490-6338Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Reinspection 2
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B05 PA006112-3 87 3 0 Approved 0.000
Billing Address:
,
Notes:
Page 63 of 466
Inspector Acknowledged Receipt: ELEANOR BOHMER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/29/2010 Business ID: 00021574 Inspection: AU000731Business: NEW MARKET CONVENIENCE Store #:
1130 NEW MARKET RD Phone: (804)222-7767Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO RB78 16765-1 87 1 0 Approved 5.000 C-8179
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 64 of 466
Inspector Acknowledged Receipt: ASHVIN PATEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/1/2010 Business ID: 00111218 Inspection: AU000733Business: BROOK RD EXXON Store #:
8627 BROOK RD Phone: 804-368-1025Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Placed into Service
Class Actv App Rej Con CwC NTLiquid Measuring Device 28 28
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 DWEN195826-1 87 1 0 Approved 5.000GILBARCO NN1 DWEN195826-1 89 1 0 Approved 5.000GILBARCO NN1 DWEN195826-1 93 1 0 Approved 5.000GILBARCO NN1 DWEN195826-2 87 2 0 Approved 5.000GILBARCO NN1 DWEN195826-2 89 2 0 Approved 5.000GILBARCO NN1 DWEN195826-2 93 2 0 Approved 5.000GILBARCO NN1 DWEN195823-3 87 3 0 Approved 5.000GILBARCO NN1 DWEN195823-3 89 3 0 Approved 5.000GILBARCO NN1 DWEN195823-3 93 3 0 Approved 5.000GILBARCO NN1 DWEN195823-4 87 4 0 Approved 5.000GILBARCO NN1 DWEN195823-4 89 4 0 Approved 5.000GILBARCO NN1 DWEN195823-4 93 4 0 Approved 5.000GILBARCO NN1 DWEN195825-5 87 5 0 Approved 5.000GILBARCO NN1 DWEN195825-5 89 5 0 Approved 5.000GILBARCO NN1 DWEN195825-5 93 5 0 Approved 5.000GILBARCO NN1 DWEN195825-6 87 6 0 Approved 5.000GILBARCO NN1 DWEN195825-6 89 6 0 Approved 5.000GILBARCO NN1 DWEN195825-6 93 6 0 Approved 5.000GILBARCO NN1 DWEN195824-7 87 7 0 Approved 5.000GILBARCO NN1 DWEN195824-7 89 7 0 Approved 5.000GILBARCO NN1 DWEN195824-7 93 7 0 Approved 5.000
Page 65 of 466
Inspector Acknowledged Receipt: JIT U
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 DWEN195824-8 87 8 0 Approved 5.000GILBARCO NN1 DWEN195824-8 89 8 0 Approved 5.000GILBARCO NN1 DWEN195824-8 93 8 0 Approved 5.000GILBARCO JH000 LAO17207-9 Diesel 9 0 Approved 5.000GILBARCO JC1300 LAO55222-10 Kerosene 10 0 Approved 5.000GILBARCO JHA400 LAO97165-11 Diesel 11 0 Approved 5.000GILBARCO JHA400 LAO97165-12 Diesel 12 0 Approved 5.000
Device Product Used: 140. Insp Product Used: . Tot Product Used: 140.Grade Prod Used87 40.0089 40.0093 40.00Diesel 15.00Kerosene 5.00
Billing Address:
,
Notes:
Page 66 of 466
Inspector Acknowledged Receipt: JIT U
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/1/2010 Business ID: 00193541 Inspection: AU000734Business: SHEETZ Store #: #350
7035 W BROAD STREET Phone: 804-755-6042Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23294 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 3 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO EN1 HMEC002347-16 87 16 0 Approved 1.000GILBARCO EN1 HMEC002347-16 89 16 0 Approved 0.000GILBARCO EN1 HMEC002347-16 93 16 0 Approved 0.000
Device Product Used: 1. Insp Product Used: . Tot Product Used: 1.Grade Prod Used87 1.00
Billing Address:
,
Notes:
Page 67 of 466
Inspector Acknowledged Receipt: WILLIAM CRASE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/9/2010 Business ID: 00240624 Inspection: AU000741Business: RIDGEFIELD EXXON Store #:
10400 RIDGEFIELD PARKWAY Phone: (804)740-1990Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 3 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 pa171308-1 87 1 0 Approved 5.000GILBARCO B79 pa171308-1 89 1 0 Approved 5.000GILBARCO B79 pa171308-1 93 1 0 Approved 5.000
Device Product Used: 15. Insp Product Used: . Tot Product Used: 15.Grade Prod Used87 5.0089 5.0093 5.00
Billing Address:
,
Notes:
PUMP # 1 ALL GRADE WAS PUT BACK INTO SERVICE
Page 68 of 466
Inspector Acknowledged Receipt: MEGHA R RANA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/9/2010 Business ID: 00240624 Inspection: AU000742Business: RIDGEFIELD EXXON Store #:
10400 RIDGEFIELD PARKWAY Phone: (804)740-1990Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B7C PA171311-5 87 5 0 Approved 5.000 C-8196
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 69 of 466
Inspector Acknowledged Receipt: MEGHA R RANA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/23/2010 Business ID: 00163583 Inspection: AU000746Business: NORTH PARK SHELL Store #: #10
805 PARHAM RD Phone: 804-266-4407Inspector: 325 MIKE TILLMAN
RICHM0ND, VA 23227 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B78 PA141848-12 87 12 -2 Condemned 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
Page 70 of 466
Inspector Acknowledged Receipt: JHON CANOVA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 71 of 466
Inspector Acknowledged Receipt: JHON CANOVA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/27/2010 Business ID: 00161691 Inspection: AU000756Business: UPPY S EXXON Store #: #36
8208 W BROAD ST Phone: 804-965-9082Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B05 PA048024-8 87 8 5 Approved 5.000 c-8222
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 72 of 466
Inspector Acknowledged Receipt: AARON LAMOY
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/29/2010 Business ID: 00163583 Inspection: AU000759Business: NORTH PARK SHELL Store #: #10
805 PARHAM RD Phone: 804-266-4407Inspector: 325 MIKE TILLMAN
RICHM0ND, VA 23227 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B78 PA141848-12 87 12 0 Approved 1.000
Device Product Used: 1. Insp Product Used: . Tot Product Used: 1.Grade Prod Used87 1.00
Billing Address:
,
Notes:
Page 73 of 466
Inspector Acknowledged Receipt: TIFFANY BAKER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/6/2010 Business ID: 00110387 Inspection: AU000768Business: FOOD MART Store #:
4105 S LABURNUM AVE Phone: 804-226-0495Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA143947-8 87 8 3 Approved 5.000 C#8232
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 74 of 466
Inspector Acknowledged Receipt: NADYA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/16/2010 Business ID: 00110881 Inspection: AU000779Business: WAWA Store #: #677
8800 BROOK RD Phone: 804-264-4698Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 2 2
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA225212-11 87 11 0 Approved 0.000GILBARCO B79 PA225213-14 87 14 0 Approved 0.000
Billing Address:
,
Notes:
complaint # 8247 no problem found.
Page 75 of 466
Inspector Acknowledged Receipt: PEDRO VAZQUEZ
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/16/2010 Business ID: 00271875 Inspection: AU000780Business: WAWA Store #: #655
5231 BROOK RD Phone: (804)266-1031Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23227 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 BREN088461-2 87 2 0 Approved 0.000
Billing Address:
,
Notes:
COMPLAINT # 8248 NO PROBLEM FOUND
Page 76 of 466
Inspector Acknowledged Receipt: LYNDA J NAZZARO
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/16/2010 Business ID: 00500738 Inspection: AU000781Business: BJ'S WHOLESALE CLUB Store #: #198
1320 STARLING DRIVE Phone: 804-727-3505Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 3/V590D5/D2G 48718B-3 87 3 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
AD SIGN & PUMP PRICES MATCHING CHECKED METER AT 5 GAL. NO PROBLEM FOUND
Page 77 of 466
Inspector Acknowledged Receipt: PAUL FERGUSON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/18/2010 Business ID: 00021685 Inspection: AU000782Business: LUCKYS Store #:
607 E LABURNUM AVE Phone: 804-329-9349Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23222 Reason: Complaint
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B12/3223D1/JK 63005A-7 87 7 -8 Rejected 5.000 C-8262
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
Page 78 of 466
Inspector Acknowledged Receipt: OMAR LUQMAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 79 of 466
Inspector Acknowledged Receipt: OMAR LUQMAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 9/3/2010 Business ID: 00021685 Inspection: AU000811Business: LUCKYS Store #:
607 E LABURNUM AVE Phone: 804-329-9349Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23222 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B12/3223D1/JK 63005A-7 87 7 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 80 of 466
Inspector Acknowledged Receipt: omar luqman
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 10/15/2010 Business ID: 00501021 Inspection: AU000856Business: WAWA Store #: 8617
11052 W. BROAD Phone: 804-527-8302Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Placed into Service
Class Actv App Rej Con CwC NTLiquid Measuring Device 36 36Gas Station 1 1Small Capacity Scale 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 LUEN177264-1 87 1 0 Approved 5.000GILBARCO NN1 LUEN177264-1 89 1 0 Approved 5.000GILBARCO NN1 LUEN177264-1 93 1 0 Approved 5.000GILBARCO NN1 LUEN177264-2 87 2 0 Approved 5.000GILBARCO NN1 LUEN177264-2 89 2 0 Approved 5.000GILBARCO NN1 LUEN177264-2 93 2 0 Approved 5.000GILBARCO NN1 LUEN177262-3 87 3 0 Approved 5.000GILBARCO NN1 LUEN177262-3 89 3 0 Approved 5.000GILBARCO NN1 LUEN177262-3 93 3 0 Approved 5.000GILBARCO NN1 LUEN177262-4 87 4 0 Approved 5.000GILBARCO NN1 LUEN177262-4 89 4 0 Approved 5.000GILBARCO NN1 LUEN177262-4 93 4 0 Approved 5.000GILBARCO NN1 LUEN177261-5 87 5 0 Approved 5.000GILBARCO NN1 LUEN177261-5 89 5 0 Approved 5.000GILBARCO NN1 LUEN177261-5 93 5 0 Approved 5.000GILBARCO NN1 LUEN177261-6 87 6 0 Approved 5.000GILBARCO NN1 LUEN177261-6 89 6 0 Approved 5.000GILBARCO NN1 LUEN177261-6 93 6 0 Approved 5.000GILBARCO NN1 LUEN177263-7 87 7 0 Approved 5.000
Page 81 of 466
Inspector Acknowledged Receipt: sTACEY mYERS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 LUEN177263-7 89 7 0 Approved 5.000GILBARCO NN1 LUEN177263-7 93 7 0 Approved 5.000GILBARCO NN1 LUEN177263-8 87 8 0 Approved 5.000GILBARCO NN1 LUEN177263-8 89 8 0 Approved 5.000GILBARCO NN1 LUEN177263-8 93 8 0 Approved 5.000GILBARCO NN1 LUEN177260-9 87 9 0 Approved 5.000GILBARCO NN1 LUEN177260-9 89 9 0 Approved 5.000GILBARCO NN1 LUEN177260-9 93 9 0 Approved 5.000GILBARCO NN1 LUEN177260-10 87 10 0 Approved 5.000GILBARCO NN1 LUEN177260-10 89 10 0 Approved 5.000GILBARCO NN1 LUEN177260-10 93 10 0 Approved 5.000GILBARCO NN1 LUEN177265-11 87 11 0 Approved 5.000GILBARCO NN1 LUEN177265-11 89 11 0 Approved 5.000GILBARCO NN1 LUEN177265-11 93 11 0 Approved 5.000GILBARCO NN1 LUEN177265-12 87 12 0 Approved 5.000GILBARCO NN1 LUEN177265-12 89 12 0 Approved 5.000GILBARCO NN1 LUEN177265-12 93 12 0 Approved 5.000
Device Product Used: 180. Insp Product Used: . Tot Product Used: 180.Grade Prod Used87 60.0089 60.0093 60.00
Billing Address:
,
Notes:
Page 82 of 466
Inspector Acknowledged Receipt: sTACEY mYERS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/10/2010 Business ID: 00111766 Inspection: AU000881Business: WORLD MINI MARKET Store #: #664
9015 QUIOCCASIN RD Phone: (804-781-6905Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
11/10/10 05:00 PM 05:32 PM 0:32 0:00 0:32Total: 0:32 0:00 0:32
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B70 PA120845-2 87 2 0 Approved 0.000
Billing Address:
,
Notes:
Page 83 of 466
Inspector Acknowledged Receipt: YANA PONOMARENKO
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/12/2010 Business ID: 00161994 Inspection: AU000882Business: MAC CHEVRON Store #:
1504 EAST RIDGE RD Phone: (804)658-4508Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229-5740 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
11/12/10 09:00 AM 09:40 AM 0:40 0:00 0:40Total: 0:40 0:00 0:40
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H422C 1199126902414-2 87 2 0 Rejected 0.000price per gal glass broken
Billing Address:
,
Notes:
Station missing Brand labeling on all pumps and station.
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 84 of 466
Inspector Acknowledged Receipt: BALLI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 85 of 466
Inspector Acknowledged Receipt: BALLI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/12/2010 Business ID: 00111215 Inspection: AU000883Business: LAKESIDE CITGO Store #: #36
5301 LAKESIDE AVE Phone: 804-262-2181Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
11/12/10 10:17 AM 11:00 AM 0:43 0:00 0:43Total: 0:43 0:00 0:43
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE V580D1/GOY 651468-2 87 2 -1 Rejected 1.000press button was broken no other probloms
Device Product Used: 1. Insp Product Used: . Tot Product Used: 1.Grade Prod Used87 1.00
Billing Address:
,
Notes:
Page 86 of 466
Inspector Acknowledged Receipt: MIKE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Page 87 of 466
Inspector Acknowledged Receipt: MIKE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 88 of 466
Inspector Acknowledged Receipt: MIKE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/22/2010 Business ID: 00021599 Inspection: AU000889Business: BROAD ST MILLER MART Store #:
8430 W BROAD ST Phone: (804)346-9806Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
11/22/10 03:26 PM 03:46 PM 0:20 0:00 0:20 complaint # 8390Total: 0:20 0:00 0:20
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H426BPMK1P1 PMP15069-7 87 7 0 Approved 0.000
Billing Address:
,
Notes:
Page 89 of 466
Inspector Acknowledged Receipt: NIMISHA SHETH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/21/2010 Business ID: 00113715 Inspection: AU000927Business: WOODMAN FOOD MART Store #:
9024 WOODMAN RD Phone: (804)266-9241Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
12/21/10 02:13 PM 03:15 PM 1:02 0:00 1:02 C- 8435Total: 1:02 0:00 1:02
Class Actv App Rej Con CwC NTLiquid Measuring Device 4 1 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B65 PA024145-1 89 1 0 Condemned 0.000GILBARCO B65 PA024145-1 93 1 0 Condemned 0.000GILBARCO B65 PA024145-2 89 2 0 Condemned 0.000GILBARCO B65 PA024145-2 93 2 0 Rejected 0.000
Billing Address:
,
Notes:
PUMP # 1 93 & 89 METER JUMP AT STARTUP
Page 90 of 466
Inspector Acknowledged Receipt: SUNNY THOBANI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
PUMP # 2 89 METER JUMP AT STARTUP 93 & 89 MISSING OCTANE LABEL
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1
Page 91 of 466
Inspector Acknowledged Receipt: SUNNY THOBANI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 92 of 466
Inspector Acknowledged Receipt: SUNNY THOBANI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 1/10/2011 Business ID: 00113956 Inspection: AU000949Business: 7-ELEVEN Store #: #32603
11480 W BROAD ST Phone: 804-364-4108Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
01/10/11 11:10 AM 11:55 AM 0:45 0:00 0:45 C-8466 NO PROBLEM FOUNDTotal: 0:45 0:00 0:45
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO 7B30 PA18027-3 93 3 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used93 5.00
Billing Address:
,
Notes:
NO PROBLEM WAS FOUND
Page 93 of 466
Inspector Acknowledged Receipt: B BABU
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 1/10/2011 Business ID: 00111207 Inspection: AU000950Business: EAST COAST Store #: #59
9800 W BROAD ST Phone: (804)370-8110Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
01/10/11 12:35 AM 01:40 PM 13:05 0:00 13:05Total: 13:05 0:00 13:05
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H322B-IV-RIT2 77PMP042116-14 Diesel 14 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod UsedDiesel 5.00
Billing Address:
,
Notes:
Page 94 of 466
Inspector Acknowledged Receipt: JANIS HEWITT
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 2/10/2011 Business ID: 00111765 Inspection: AU000983Business: ZOTAS CITGO Store #: #662
7834 PARHAM RD Phone: (804)747-6090Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
02/10/11 11:30 AM 12:00 PM 0:30 0:00 0:30 C-8527 ANTI DRAIN MEANSTotal: 0:30 0:00 0:30
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA094306-2 87 2 0 Condemned 0.000
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 95 of 466
Inspector Acknowledged Receipt: MB SAIFUL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 96 of 466
Inspector Acknowledged Receipt: MB SAIFUL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 2/11/2011 Business ID: 00113715 Inspection: AU000986Business: WOODMAN FOOD MART Store #:
9024 WOODMAN RD Phone: (804)266-9241Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 3 2 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B65 PA024145-1 89 1 0 Approved 0.000GILBARCO B65 PA024145-1 93 1 0 Condemned 0.000GILBARCO B65 PA024145-2 89 2 0 Approved 0.000
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
Page 97 of 466
Inspector Acknowledged Receipt: A THOBANI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 98 of 466
Inspector Acknowledged Receipt: A THOBANI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/3/2011 Business ID: 00112020 Inspection: AU001031Business: MILLER MART Store #: #67
11301 NUCKOLS RD Phone: 804-270-5061Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23059 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
03/03/11 02:55 PM 03:25 PM 0:30 0:00 0:30 C-8571Total: 0:30 0:00 0:30
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 EN016742-6 87 6 0 Rejected 1.000
Device Product Used: 1. Insp Product Used: . Tot Product Used: 1.Grade Prod Used87 1.00
Billing Address:
,
Notes:
missing segment on total gallons
Page 99 of 466
Inspector Acknowledged Receipt: KELLIE LAPELHH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Page 100 of 466
Inspector Acknowledged Receipt: KELLIE LAPELHH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 101 of 466
Inspector Acknowledged Receipt: KELLIE LAPELHH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/16/2011 Business ID: 00113715 Inspection: AU001056Business: WOODMAN FOOD MART Store #:
9024 WOODMAN RD Phone: (804)266-9241Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Reinspection 2
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B65 PA024145-1 93 1 0 Condemned 0.000
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
Page 102 of 466
Inspector Acknowledged Receipt: SUNNY THOBANI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 103 of 466
Inspector Acknowledged Receipt: SUNNY THOBANI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/16/2011 Business ID: 00112020 Inspection: AU001057Business: MILLER MART Store #: #67
11301 NUCKOLS RD Phone: 804-270-5061Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23059 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 EN016742-6 87 6 0 Approved 0.000
Billing Address:
,
Notes:
Page 104 of 466
Inspector Acknowledged Receipt: DEBBIE GANTT
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/18/2011 Business ID: 00113725 Inspection: AU001067Business: FAS MART Store #: #30
11390 NUCKOLS RD Phone: (804)270-4494Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
03/18/11 12:03 PM 12:35 PM 0:32 0:00 0:32 C-8591 NO PROBLEM FOUNDTotal: 0:32 0:00 0:32
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NL1 DSEN125117-8 87 9 4 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 105 of 466
Inspector Acknowledged Receipt: PATRICIA MCINTYRE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/21/2011 Business ID: 00500737 Inspection: AU001069Business: UPPYS # 28 Store #: #28
3101 LAUDERDALE DR Phone: 804-360-0269Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 38 35 3Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 GSEN130310-5 87 5 -2 Approved 5.000GILBARCO NN1 GSEN130311-1 87 1 0 Approved 5.000GILBARCO NN1 GSEN130311-1 89 1 0 Approved 5.000GILBARCO NN1 GSEN130311-1 93 1 -2 Approved 5.000GILBARCO NN1 GSEN130211-2 87 2 0 Approved 5.000GILBARCO NN1 GSEN130211-2 89 2 0 Approved 5.000GILBARCO NN1 GSEN130211-2 93 2 0 Approved 5.000GILBARCO NN1 GSEN130312-3 87 3 -3 Approved 5.000GILBARCO NN1 GSEN130312-3 89 3 -2 Approved 5.000GILBARCO NN1 GSEN130312-3 93 3 -1 Approved 5.000GILBARCO NN1 GSEN130312-4 87 4 -2 Approved 5.000GILBARCO NN1 GSEN130312-4 89 4 -3 Approved 5.000GILBARCO NN1 GSEN130312-4 93 4 0 Approved 5.000GILBARCO NN1 GSEN130310-5 89 5 -3 Approved 5.000GILBARCO NN1 GSEN130310-5 93 5 -3 Approved 5.000GILBARCO NN1 GSEN130310-6 87 6 -3 Approved 5.000GILBARCO NN1 GSEN130310-6 89 6 -1 Approved 5.000GILBARCO NN1 GSEN130310-6 93 6 -3 Approved 5.000GILBARCO NN1 GSEN130313-7 87 7 0 Not Tested 0.000GILBARCO NN1 GSEN130313-7 89 7 0 Not Tested 0.000
Page 106 of 466
Inspector Acknowledged Receipt: DAVID ADDINGTON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 GSEN130313-7 93 7 0 Not Tested 0.000GILBARCO NN1 GSEN130313-8 87 8 -3 Approved 5.000GILBARCO NN1 GSEN130313-8 89 8 -3 Approved 5.000GILBARCO NN1 GSEN130313-8 93 8 -3 Approved 5.000GILBARCO NN1 GSEN130309-9 87 9 0 Approved 5.000GILBARCO NN1 GSEN130309-9 89 9 1 Approved 5.000GILBARCO NN1 GSEN130309-9 93 9 1 Approved 5.000GILBARCO NN1 GSEN130309-10 87 10 -2 Approved 5.000GILBARCO NN1 GSEN130309-10 89 10 0 Approved 5.000GILBARCO NN1 GSEN130309-10 93 10 0 Approved 5.000GILBARCO NL1 GSEN130145-11 87 11 -2 Approved 5.000GILBARCO NL1 GSEN130145-11 89 11 -2 Approved 5.000GILBARCO NL1 GSEN130145-11 93 11 -2 Approved 5.000GILBARCO NL1 GSEN130145-11 Diesel 11 0 Approved 5.000GILBARCO NL1 GSEN130145-12 87 12 -2 Approved 5.000GILBARCO NL1 GSEN130145-12 89 12 -2 Approved 5.000GILBARCO NL1 GSEN130145-12 93 12 -2 Approved 5.000GILBARCO NL1 GSEN130145-12 Diesel 12 0 Approved 5.000
Device Product Used: 175. Insp Product Used: . Tot Product Used: 175.Grade Prod Used87 55.0089 55.0093 55.00Diesel 10.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 107 of 466
Inspector Acknowledged Receipt: DAVID ADDINGTON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 108 of 466
Inspector Acknowledged Receipt: DAVID ADDINGTON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/21/2011 Business ID: 00161691 Inspection: AU001070Business: UPPY S EXXON Store #: #36
8208 W BROAD ST Phone: 804-965-9082Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 36 34 1 1Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B05 PA048024-8 87 8 0 Rejected 0.000GILBARCO B05 PA072629-1 87 1 0 Approved 5.000GILBARCO B05 PA072629-1 89 1 0 Approved 5.000GILBARCO B05 PA072629-1 93 1 0 Condemned 5.000GILBARCO B05 PA072629-2 87 2 0 Approved 5.000GILBARCO B05 PA072629-2 89 2 0 Approved 5.000GILBARCO B05 PA072629-2 93 2 0 Approved 5.000GILBARCO B05 PA048022-3 87 3 0 Approved 5.000GILBARCO B05 PA048022-3 89 3 0 Approved 5.000GILBARCO B05 PA048022-3 93 3 0 Approved 5.000GILBARCO B05 PA048022-4 87 4 0 Approved 5.000GILBARCO B05 PA048022-4 89 4 0 Approved 5.000GILBARCO B05 PA048022-4 93 4 0 Approved 5.000GILBARCO B05 PA048028-5 87 5 0 Approved 5.000GILBARCO B05 PA048028-5 89 5 0 Approved 5.000GILBARCO B05 PA048028-5 93 5 0 Approved 5.000GILBARCO B05 PA048028-6 87 6 0 Approved 5.000GILBARCO B05 PA048028-6 89 6 0 Approved 5.000GILBARCO B05 PA048028-6 93 6 0 Approved 5.000GILBARCO B05 PA048024-7 87 7 0 Approved 5.000
Page 109 of 466
Inspector Acknowledged Receipt: CATHY NELSON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B05 PA048024-7 89 7 0 Approved 5.000GILBARCO B05 PA048024-7 93 7 0 Approved 5.000GILBARCO B05 PA048024-8 89 8 0 Approved 5.000GILBARCO B05 PA048024-8 93 8 0 Approved 5.000GILBARCO B05 PA048023-9 87 9 0 Approved 5.000GILBARCO B05 PA048023-9 89 9 0 Approved 5.000GILBARCO B05 PA048023-9 93 9 0 Approved 5.000GILBARCO B05 PA048023-10 87 10 0 Approved 5.000GILBARCO B05 PA048023-10 89 10 0 Approved 5.000GILBARCO B05 PA048023-10 93 10 0 Approved 5.000GILBARCO B05 PA048021-11 87 11 0 Approved 5.000GILBARCO B05 PA048021-11 89 11 0 Approved 5.000GILBARCO B05 PA048021-11 93 11 0 Approved 5.000GILBARCO B05 PA048021-12 87 12 0 Approved 5.000GILBARCO B05 PA048021-12 89 12 0 Approved 5.000GILBARCO B05 PA048021-12 93 12 0 Approved 5.000
Device Product Used: 175. Insp Product Used: . Tot Product Used: 175.Grade Prod Used87 55.0089 60.0093 60.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
Page 110 of 466
Inspector Acknowledged Receipt: CATHY NELSON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 111 of 466
Inspector Acknowledged Receipt: CATHY NELSON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/22/2011 Business ID: 00110560 Inspection: AU001073Business: PARHAM BP Store #:
9100 THREE CHOPT RD Phone: 804-270-4798Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 30 28 2
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H426B- PMR036446-1 87 1 0 Approved 5.000TOKHEIM H426B- PMR036446-1 89 1 0 Approved 5.000TOKHEIM H426B- PMR036446-1 93 1 0 Approved 5.000TOKHEIM H426B- PMR036446-2 87 2 0 Approved 5.000TOKHEIM H426B- PMR036446-2 89 2 0 Approved 5.000TOKHEIM H426B- PMR036446-2 93 2 0 Approved 5.000TOKHEIM H426B- PMR036427-3 87 3 0 Approved 5.000TOKHEIM H426B- PMR036427-3 89 3 0 Approved 5.000TOKHEIM H426B- PMR036427-3 93 3 0 Approved 5.000TOKHEIM H426B- PMR036427-4 87 4 0 Approved 5.000TOKHEIM H426B- PMR036427-4 89 4 0 Approved 5.000TOKHEIM H426B- PMR036427-4 93 4 0 Approved 5.000TOKHEIM H426B- PMR036422-5 87 5 0 Approved 5.000TOKHEIM H426B- PMR036422-5 89 5 0 Approved 5.000TOKHEIM H426B- PMR036422-5 93 5 0 Approved 5.000TOKHEIM H426B- PMR036422-6 87 6 0 Approved 5.000TOKHEIM H426B- PMR036422-6 89 6 0 Approved 5.000TOKHEIM H426B- PMR036422-6 93 6 0 Approved 5.000TOKHEIM H426B- PMR036438-7 87 7 0 Approved 5.000TOKHEIM H426B- PMR036438-7 89 7 0 Approved 5.000TOKHEIM H426B- PMR036438-7 93 7 0 Approved 5.000
Page 112 of 466
Inspector Acknowledged Receipt: MANISH PATEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H426B- PMR036438-8 87 8 0 Approved 5.000TOKHEIM H426B- PMR036438-8 89 8 0 Approved 5.000TOKHEIM H426B- PMR036438-8 93 8 0 Approved 5.000TOKHEIM H426B- PMR036426-9 87 9 -13 Rejected 5.000TOKHEIM H426B- PMR036426-9 89 9 -5 Approved 10.000TOKHEIM H426B- PMR036426-9 93 9 0 Approved 5.000TOKHEIM H426B- PMR036426-10 87 10 0 Approved 5.000TOKHEIM H426B- PMR036426-10 89 10 0 Approved 5.000TOKHEIM H426B- PMR036426-10 93 10 0 Rejected 0.000
Device Product Used: 150. Insp Product Used: . Tot Product Used: 150.Grade Prod Used87 50.0089 55.0093 45.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANS
Page 113 of 466
Inspector Acknowledged Receipt: MANISH PATEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Service Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 114 of 466
Inspector Acknowledged Receipt: MANISH PATEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/22/2011 Business ID: 00022332 Inspection: AU001074Business: PATTERSON PIT STOP Store #: #555
9612 PATTERSON AVE Phone: (804)740-9572Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 24 24Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NG0 KSEN136148-1 87 1 0 Approved 5.000GILBARCO NG0 KSEN136148-1 89 1 0 Approved 5.000GILBARCO NG0 KSEN136148-1 93 1 0 Approved 5.000GILBARCO NG0 KSEN136148-2 87 2 0 Approved 5.000GILBARCO NG0 KSEN136148-2 89 2 0 Approved 5.000GILBARCO NG0 KSEN136148-2 93 2 0 Approved 5.000GILBARCO NG0 KSEN136147-3 87 3 0 Approved 5.000GILBARCO NG0 KSEN136147-3 89 3 0 Approved 5.000GILBARCO NG0 KSEN136147-3 93 3 0 Approved 5.000GILBARCO NG0 KSEN136147-4 87 4 0 Approved 5.000GILBARCO NG0 KSEN136147-4 89 4 0 Approved 5.000GILBARCO NG0 KSEN136147-4 93 4 0 Approved 5.000GILBARCO NG0 KSEN136146-5 87 5 0 Approved 5.000GILBARCO NG0 KSEN136146-5 89 5 0 Approved 5.000GILBARCO NG0 KSEN136146-5 93 5 0 Approved 5.000GILBARCO NG0 KSEN136146-6 87 6 0 Approved 5.000GILBARCO NG0 KSEN136146-6 89 6 0 Approved 5.000GILBARCO NG0 KSEN136146-6 93 6 0 Approved 5.000GILBARCO NG0 KSEN136149-7 87 7 0 Approved 5.000GILBARCO NG0 KSEN136149-7 89 7 0 Approved 5.000
Page 115 of 466
Inspector Acknowledged Receipt: TOWANDA PUCKETT
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NG0 KSEN136149-7 93 7 0 Approved 5.000GILBARCO NG0 KSEN136149-8 87 8 0 Approved 5.000GILBARCO NG0 KSEN136149-8 89 8 0 Approved 5.000GILBARCO NG0 KSEN136149-8 93 8 0 Approved 5.000
Device Product Used: 120. Insp Product Used: . Tot Product Used: 120.Grade Prod Used87 40.0089 40.0093 40.00
Billing Address:
,
Notes:
Page 116 of 466
Inspector Acknowledged Receipt: TOWANDA PUCKETT
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/22/2011 Business ID: 00110996 Inspection: AU001075Business: KROGER Store #: #500
9480 W BROAD ST Phone: 804-270-5896Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23294 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 30 30Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B12/3220D1/JK 26313-1 87 1 0 Approved 5.000WAYNE B12/3220D1/JK 26314-5 87 5 0 Approved 5.000WAYNE B12/3220D1/JK 26313-1 89 1 0 Approved 5.000WAYNE B12/3220D1/JK 26314-5 89 5 0 Approved 5.000WAYNE B12/3220D1/JK 26313-1 93 1 0 Approved 5.000WAYNE B12/3220D1/JK 26314-5 93 5 0 Approved 5.000WAYNE B12/3220D1/JK 26313-2 87 2 0 Approved 5.000WAYNE B12/3220D1/JK 26313-2 89 2 0 Approved 5.000WAYNE B12/3220D1/JK 26313-2 93 2 0 Approved 5.000WAYNE B12/3220D1/JK 26316-3 87 3 0 Approved 5.000WAYNE B12/3220D1/JK 26316-3 89 3 0 Approved 5.000WAYNE B12/3220D1/JK 26316-3 93 3 0 Approved 5.000WAYNE B12/3220D1/JK 26316-4 87 4 0 Approved 5.000WAYNE B12/3220D1/JK 26316-4 89 4 0 Approved 5.000WAYNE B12/3220D1/JK 26316-4 93 4 0 Approved 5.000WAYNE B12/3220D1/JK 26314-6 87 6 0 Approved 5.000WAYNE B12/3220D1/JK 26314-6 89 6 0 Approved 5.000WAYNE B12/3220D1/JK 26314-6 93 6 0 Approved 5.000WAYNE B12/3220D1/JK 26315-7 87 7 0 Approved 5.000WAYNE B12/3220D1/JK 26315-7 89 7 0 Approved 5.000
Page 117 of 466
Inspector Acknowledged Receipt: JASON STEWART
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B12/3220D1/JK 26315-7 93 7 0 Approved 5.000WAYNE B12/3220D1/JK 26315-8 87 8 0 Approved 5.000WAYNE B12/3220D1/JK 26315-8 89 8 0 Approved 5.000WAYNE B12/3220D1/JK 26315-8 93 8 0 Approved 5.000WAYNE B12/3220D1/JK 26312-9 87 9 0 Approved 5.000WAYNE B12/3220D1/JK 26312-9 89 9 0 Approved 5.000WAYNE B12/3220D1/JK 26312-9 93 9 0 Approved 5.000WAYNE B12/3220D1/JK 26312-10 87 10 0 Approved 5.000WAYNE B12/3220D1/JK 26312-10 89 10 0 Approved 5.000WAYNE B12/3220D1/JK 26312-10 93 10 0 Approved 5.000
Device Product Used: 150. Insp Product Used: . Tot Product Used: 150.Grade Prod Used87 50.0089 50.0093 50.00
Billing Address:
,
Notes:
Page 118 of 466
Inspector Acknowledged Receipt: JASON STEWART
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/23/2011 Business ID: 00112911 Inspection: AU001076Business: STAPLES MILL SHELL Store #: #116954
6001 STAPLES MILL RD Phone: (804)264-1900Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 40 24 15 1Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 1/V58D4/GQY 724232-1 87 1 0 Approved 5.000WAYNE 1/V58D4/GQY 724232-1 89 1 0 Approved 5.000WAYNE 1/V58D4/GQY 724232-1 93 1 0 Approved 5.000WAYNE 1/V58D4/GQY 724232-2 87 2 0 Approved 5.000WAYNE 1/V58D4/GQY 724232-2 89 2 0 Approved 5.000WAYNE 1/V58D4/GQY 724232-2 93 2 0 Approved 5.000WAYNE 1/V58D4/GQY 724234-5 87 5 0 Approved 5.000WAYNE 1/V58D4/GQY 724234-5 89 5 0 Approved 5.000WAYNE 1/V58D4/GQY 724234-5 93 5 0 Approved 5.000WAYNE 1/V58D4/GQY 724234-6 87 6 0 Approved 5.000WAYNE 1/V58D4/GQY 724234-6 89 6 0 Approved 5.000WAYNE 1/V58D4/GQY 724234-6 93 6 0 Approved 5.000WAYNE 1/V58D4/GQY 724231-7 87 7 0 Approved 5.000WAYNE 1/V58D4/GQY 724231-7 89 7 0 Approved 5.000WAYNE 1/V58D4/GQY 724231-7 93 7 0 Approved 5.000WAYNE 1/V58D4/GQY 724231-8 87 8 0 Approved 5.000WAYNE 1/V58D4/GQY 724231-8 89 8 0 Approved 5.000WAYNE 1/V58D4/GQY 724231-8 93 8 0 Approved 5.000WAYNE 1/V58D4/GQY 724233-9 87 9 0 Approved 5.000WAYNE 1/V58D4/GQY 724233-9 89 9 0 Approved 5.000
Page 119 of 466
Inspector Acknowledged Receipt: ARSHAD MAHMOOD
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 1/V58D4/GQY 724233-9 93 9 0 Approved 5.000WAYNE 1/V58D4/GQY 724233-10 87 10 0 Approved 5.000WAYNE 1/V58D4/GQY 724233-10 89 10 0 Approved 5.000WAYNE 1/V58D4/GQY 724233-10 93 10 0 Approved 5.000WAYNE 2/595D4 722340-3 87 3 0 Rejected 5.000WAYNE 2/595D4 722340-3 89 3 0 Rejected 5.000WAYNE 2/595D4 722340-3 93 3 0 Rejected 5.000WAYNE 2/595D4 722340-3 Diesel 3 0 Rejected 5.000WAYNE 2/595D4 722340-4 87 4 0 Rejected 5.000WAYNE 2/595D4 722340-4 89 4 0 Rejected 5.000WAYNE 2/595D4 722340-4 93 4 0 Rejected 5.000WAYNE 2/595D4 722340-4 Diesel 4 0 Rejected 5.000WAYNE 2/595D4 734995-11 87 11 0 Rejected 5.000WAYNE 2/595D4 734995-11 89 11 0 Rejected 5.000WAYNE 2/595D4 734995-11 93 11 0 Rejected 5.000WAYNE 2/595D4 734995-11 Diesel 11 0 Rejected 5.000WAYNE 2/595D4 733995-12 87 12 0 Rejected 5.000WAYNE 2/595D4 733995-12 89 12 0 Rejected 5.000WAYNE 2/595D4 733995-12 93 12 0 Rejected 5.000WAYNE 2/595D4 733995-12 Diesel 12 0 Condemned 5.000
Device Product Used: 200. Insp Product Used: . Tot Product Used: 200.Grade Prod Used87 60.0089 60.0093 60.00Diesel 20.00
Billing Address:
,
Notes:
PUMPS 3& 4 11 & 12 DIESEL MISSING CETANE LABEL
Page 120 of 466
Inspector Acknowledged Receipt: ARSHAD MAHMOOD
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
PUMPS 4 11& 12 MISSING 10% ETHANOL LABELS
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1
Page 121 of 466
Inspector Acknowledged Receipt: ARSHAD MAHMOOD
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 122 of 466
Inspector Acknowledged Receipt: ARSHAD MAHMOOD
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/23/2011 Business ID: 00111766 Inspection: AU001077Business: WORLD MINI MARKET Store #: #664
9015 QUIOCCASIN RD Phone: (804-781-6905Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 20 20Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B70 PA120845-1 87 1 0 Approved 5.000GILBARCO B70 PA120845-2 87 2 0 Approved 5.000GILBARCO B70 PA120845-1 89 1 0 Approved 5.000GILBARCO B70 PA120845-1 93 1 0 Approved 5.000GILBARCO B70 PA120845-2 89 2 0 Approved 5.000GILBARCO B70 PA120845-2 93 2 0 Approved 5.000GILBARCO B70 PA120844-3 87 3 0 Approved 5.000GILBARCO B70 PA120844-3 89 3 0 Approved 5.000GILBARCO B70 PA120844-3 93 3 0 Approved 5.000GILBARCO B70 PA120844-4 87 4 0 Approved 5.000GILBARCO B70 PA120844-4 89 4 0 Approved 5.000GILBARCO B70 PA120844-4 93 4 0 Approved 5.000GILBARCO B70 PA120847-5 87 5 0 Approved 5.000GILBARCO B70 PA120847-5 89 5 0 Approved 5.000GILBARCO B70 PA120847-5 93 5 0 Approved 5.000GILBARCO B70 PA120847-5 Diesel 5 0 Approved 5.000GILBARCO B70 PA120847-6 87 6 0 Approved 5.000GILBARCO B70 PA120847-6 89 6 0 Approved 5.000GILBARCO B70 PA120847-6 93 6 0 Approved 5.000GILBARCO B70 PA120847-6 Diesel 6 0 Approved 5.000
Page 123 of 466
Inspector Acknowledged Receipt: SALIM AKKAWI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Device Product Used: 100. Insp Product Used: . Tot Product Used: 100.Grade Prod Used87 30.0089 30.0093 30.00Diesel 10.00
Billing Address:
,
Notes:
Page 124 of 466
Inspector Acknowledged Receipt: SALIM AKKAWI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/24/2011 Business ID: 00193554 Inspection: AU001079Business: FAS MART Store #: #80
5101 RICH-HENRICO TNPK Phone: 804-329-1734Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23227 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 27 26 1Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B65 PA053771-1 87 1 0 Approved 5.000GILBARCO B65 PA053771-1 89 1 0 Approved 5.000GILBARCO B65 PA053771-1 93 1 0 Approved 5.000GILBARCO B65 PA053768-7 93 7 0 Approved 5.000GILBARCO B65 PA053771-2 87 2 0 Approved 5.000GILBARCO RA01921A31 KCRD2279-11 Kerosene 11 0 Approved 5.000GILBARCO B65 PA053771-2 89 2 0 Approved 5.000GILBARCO B65 PA053771-2 93 2 0 Approved 5.000GILBARCO B65 PA053769-3 87 3 0 Approved 5.000GILBARCO B65 PA053769-3 89 3 0 Approved 5.000GILBARCO B65 PA053769-3 93 3 0 Approved 5.000GILBARCO B65 PA053789-4 87 4 0 Approved 5.000GILBARCO B65 PA053789-4 89 4 0 Approved 5.000GILBARCO B65 PA053789-4 93 4 0 Approved 5.000GILBARCO B65 PA053770-5 87 5 0 Approved 5.000GILBARCO B65 PA053770-5 89 5 0 Approved 5.000GILBARCO B65 PA053770-5 93 5 0 Approved 5.000GILBARCO B65 PA053770-6 87 6 0 Approved 5.000GILBARCO B65 PA053770-6 89 6 0 Approved 5.000GILBARCO B65 PA053770-6 93 6 0 Approved 5.000
Page 125 of 466
Inspector Acknowledged Receipt: NICOLE MONK
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B65 PA053768-7 87 7 0 Approved 5.000GILBARCO B65 PA053768-7 89 7 0 Approved 5.000GILBARCO B65 PA053768-8 87 8 0 Approved 5.000GILBARCO B65 PA053768-8 89 8 0 Approved 5.000GILBARCO B65 PA053768-8 93 8 0 Condemned 5.000GILBARCO HAC5921A-91 ADR000048-9 Diesel 9 0 Approved 5.000GILBARCO HAC5921A-91 ADR000048-10 Diesel 10 0 Approved 5.000
Device Product Used: 135. Insp Product Used: . Tot Product Used: 135.Grade Prod Used87 40.0089 40.0093 40.00Diesel 10.00Kerosene 5.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANS
Page 126 of 466
Inspector Acknowledged Receipt: NICOLE MONK
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Service Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 127 of 466
Inspector Acknowledged Receipt: NICOLE MONK
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/24/2011 Business ID: 00110506 Inspection: AU001080Business: MARKET PLACE Store #: #7
625 E LABURNUM AVE Phone: 804-329-1916Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23222 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 14 14Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 KSEN137443-1 87 1 0 Approved 5.000GILBARCO NN1 KSEN137443-1 89 1 0 Approved 5.000GILBARCO NN1 KSEN137443-1 93 1 0 Approved 5.000GILBARCO NN1 KSEN137443-2 87 2 0 Approved 5.000GILBARCO NN1 KSEN137443-2 89 2 0 Approved 5.000GILBARCO NN1 KSEN137443-2 93 2 0 Approved 5.000GILBARCO NN1 KSEN137442-3 87 3 0 Approved 5.000GILBARCO NN1 KSEN137442-3 89 3 0 Approved 5.000GILBARCO NN1 KSEN137442-3 93 3 0 Approved 5.000GILBARCO NN1 KSEN137442-4 87 4 0 Approved 5.000GILBARCO NN1 KSEN137442-4 89 4 0 Approved 5.000GILBARCO NN1 KSEN137442-4 93 4 0 Approved 5.000GILBARCO JHD3 DLA009447-5 Diesel 5 0 Approved 5.000GILBARCO JHD3 DLA009446-6 Kerosene 6 0 Approved 5.000
Device Product Used: 70. Insp Product Used: . Tot Product Used: 70.Grade Prod Used87 20.0089 20.0093 20.00
Page 128 of 466
Inspector Acknowledged Receipt: DANISH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Diesel 5.00Kerosene 5.00
Billing Address:
,
Notes:
OUT OF KERO NOT SELLING AT THIS TIME
Page 129 of 466
Inspector Acknowledged Receipt: DANISH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/25/2011 Business ID: 00113700 Inspection: AU001082Business: FAS MART Store #: #52
4001 E WILLIAMSBURG RD Phone: (804)737-1300Inspector: 325 MIKE TILLMAN
SANDSTON, VA 23150 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 30 29 1Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE X1/V590D4/GJ 713375-1 87 1 0 Approved 5.000WAYNE X1/V590D4/GJ 713375-1 89 1 0 Approved 5.000WAYNE X1/V590D4/GJ 713375-1 93 1 0 Approved 5.000WAYNE X1/V590D4/GJ 713375-2 87 2 0 Approved 5.000WAYNE X1/V590D4/GJ 713375-2 89 2 0 Approved 5.000WAYNE X1/V590D4/GJ 713375-2 93 2 0 Approved 5.000WAYNE X1/V590D4/GJ 713378-3 87 3 0 Approved 5.000WAYNE X1/V590D4/GJ 713378-3 89 3 0 Approved 5.000WAYNE X1/V590D4/GJ 713378-3 93 3 0 Approved 5.000WAYNE X1/V590D4/GJ 713378-4 87 4 0 Approved 5.000WAYNE X1/V590D4/GJ 713378-4 89 4 0 Condemned 5.000WAYNE X1/V590D4/GJ 713378-4 93 4 0 Approved 5.000WAYNE X1/V590D4/GJ 713380-5 87 5 0 Approved 5.000WAYNE X1/V590D4/GJ 713380-5B 89 5 0 Approved 5.000WAYNE X1/V590D4/GJ 713380-5 93 5 0 Approved 5.000WAYNE X1/V590D4/GJ 713380-6 87 6 0 Approved 5.000WAYNE X1/V590D4/GJ 713380-6 89 6 0 Approved 5.000WAYNE X1/V590D4/GJ 713380-6 93 6 0 Approved 5.000WAYNE X1/V590D4/GJ 713377-7 87 7 0 Approved 5.000WAYNE X1/V590D4/GJ 713377-7 89 7 0 Approved 5.000
Page 130 of 466
Inspector Acknowledged Receipt: N. CAHOONB
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE X1/V590D4/GJ 713377-7 93 7 0 Approved 5.000WAYNE X1/V590D4/GJ 713377-8 87 8 0 Approved 5.000WAYNE X1/V590D4/GJ 713377-8 89 8 0 Approved 5.000WAYNE X1/V590D4/GJ 713377-8 93 8 0 Approved 5.000WAYNE X1/V590D4/GJ 713376-9 87 9 0 Approved 5.000WAYNE X1/V590D4/GJ 713376-9 89 9 0 Approved 5.000WAYNE X1/V590D4/GJ 713376-9 93 9 0 Approved 5.000WAYNE X1/V590D4/GJ 713376-10 87 10 0 Approved 5.000WAYNE X1/V590D4/GJ 713376-10 89 10 0 Approved 5.000WAYNE X1/V590D4/GJ 713376-10 93 10 0 Approved 5.000
Device Product Used: 150. Insp Product Used: . Tot Product Used: 150.Grade Prod Used87 50.0089 50.0093 50.00
Billing Address:
,
Notes:
METER CREEPS AT START UP 89 # 4
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
Page 131 of 466
Inspector Acknowledged Receipt: N. CAHOONB
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 132 of 466
Inspector Acknowledged Receipt: N. CAHOONB
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/31/2011 Business ID: 00114004 Inspection: AU001100Business: 7-ELEVEN Store #: #23883
9085 WOODMAN RD Phone: (757)490-6338Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 12 12Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B05 PA006112-3 87 3 0 Approved 5.000GILBARCO B05 PA006118-1 87 1 0 Approved 5.000GILBARCO B05 PA006118-1 89 1 0 Approved 5.000GILBARCO B05 PA006118-1 93 1 0 Approved 5.000GILBARCO B05 PA006118-2 87 2 0 Approved 5.000GILBARCO B05 PA006118-2 89 2 0 Approved 5.000GILBARCO B05 PA006118-2 93 2 0 Approved 5.000GILBARCO B05 PA006112-3 89 3 0 Approved 5.000GILBARCO B05 PA006112-3 93 3 0 Approved 5.000GILBARCO B05 PA006112-4 87 4 0 Approved 5.000GILBARCO B05 PA006112-4 89 4 0 Approved 5.000GILBARCO B05 PA006112-4 93 4 0 Approved 5.000
Device Product Used: 60. Insp Product Used: . Tot Product Used: 60.Grade Prod Used87 20.0089 20.0093 20.00
Page 133 of 466
Inspector Acknowledged Receipt: DORIS SIMS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Billing Address:
,
Notes:
Page 134 of 466
Inspector Acknowledged Receipt: DORIS SIMS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/4/2011 Business ID: 00112832 Inspection: AU001101Business: 60 MART Store #:
3109 WILLIAMSBURG RD Phone: (804)226-1059Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 28 16 12Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B70 PA104034-7 87 7 0 Rejected 0.000GILBARCO B70 PA104034-7 89 7 0 Rejected 0.000GILBARCO B70 PA104034-7 93 7 0 Rejected 0.000GILBARCO B70 PA104034-7 Diesel 7 0 Approved 5.000GILBARCO B70 PA104034-8 87 8 0 Approved 5.000GILBARCO B70 PA104034-8 89 8 0 Approved 5.000GILBARCO B79 PA104014-3 89 3 0 Rejected 5.000GILBARCO B70 PA104034-8 93 8 0 Approved 5.000GILBARCO B79 PA104014-3 93 3 0 Approved 5.000GILBARCO B70 PA104034-8 Diesel 8 0 Approved 5.000GILBARCO B79 PA104013-5 87 5 0 Rejected 5.000GILBARCO B79 PA104013-5 89 5 0 Rejected 5.000GILBARCO B79 PA104013-5 93 5 0 Rejected 5.000GILBARCO B79 PA104013-6 87 6 8 Rejected 5.000GILBARCO B79 PA104013-6 89 6 17 Rejected 5.000GILBARCO B79 PA104013-6 93 6 7 Rejected 5.000GILBARCO B79 PA104014-3 87 3 0 Rejected 5.000GILBARCO B79 PA104014-4 87 4 0 Approved 5.000GILBARCO B79 PA104014-4 89 4 0 Rejected 5.000 missing ppgGILBARCO B79 PA104014-4 93 4 0 Approved 5.000
Page 135 of 466
Inspector Acknowledged Receipt: SARAVANAN KRISHNARAJ
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 RM017289-1 87 1 0 Approved 5.000GILBARCO B79 RM017289-1 89 1 0 Approved 5.000GILBARCO B79 RM017289-1 93 1 0 Approved 5.000GILBARCO B79 RM017289-2 87 2 0 Approved 5.000GILBARCO B79 RM017289-2 89 2 0 Approved 5.000GILBARCO B79 RM017289-2 93 2 0 Approved 5.000GILBARCO NP3 FREN094808-10 Diesel 10 0 Approved 5.000GILBARCO NP3 FREN094808-9 Diesel 9 0 Approved 5.000
Device Product Used: 125. Insp Product Used: . Tot Product Used: 125.Grade Prod Used87 35.0089 35.0093 35.00Diesel 20.00
Billing Address:
,
Notes:
# 3 missing 87 label all grades price per gal faded#4 missing 89 ppg
#5 all grades ppg faded#7 87 89 & 93 abnormal performance#6 87 +8 89+17 93+7
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
Page 136 of 466
Inspector Acknowledged Receipt: SARAVANAN KRISHNARAJ
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 137 of 466
Inspector Acknowledged Receipt: SARAVANAN KRISHNARAJ
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/4/2011 Business ID: 00112856 Inspection: AU001102Business: ONE STOP MART BP Store #: #1
1301 N LABURNUM AVE Phone: (804)649-8700Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 38 20 6 12Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA098657-1 87 1 0 Not Tested 0.000 GILBARCO B79 PA098657-1 89 1 0 Not Tested 0.000 GILBARCO B79 PA098657-1 93 1 0 Not Tested 0.000 GILBARCO B79 PA098657-2 87 2 0 Not Tested 0.000 GILBARCO B79 PA098657-2 89 2 0 Not Tested 0.000 GILBARCO B79 PA098657-2 93 2 0 Not Tested 0.000 GILBARCO B79 PA098658-3 87 3 0 Approved 5.000 GILBARCO B79 PA098658-3 89 3 0 Approved 5.000 GILBARCO B79 PA098658-3 93 3 0 Approved 5.000 GILBARCO B79 PA098658-4 87 4 0 Approved 5.000 GILBARCO B79 PA098658-4 89 4 0 Approved 5.000 GILBARCO B79 PA098658-4 93 4 0 Approved 5.000GILBARCO B85 PA110936-5 87 5 0 Approved 5.000GILBARCO B85 PA110936-5 89 5 0 Approved 5.000GILBARCO B85 PA110936-5 93 5 0 Approved 5.000GILBARCO B85 PA110936-6 87 6 0 Approved 5.000GILBARCO B85 PA110936-6 89 6 0 Approved 5.000GILBARCO B85 PA110936-6 93 6 0 Approved 5.000GILBARCO B85 PA110929-7 87 7 0 Rejected 5.000GILBARCO B85 PA110929-7 89 7 0 Rejected 5.000
Page 138 of 466
Inspector Acknowledged Receipt: SUKHJINDER SINGH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B85 PA110929-7 93 7 0 Rejected 5.000GILBARCO B85 PA110929-8 87 8 0 Rejected 5.000GILBARCO B85 PA110929-8 89 8 0 Rejected 5.000GILBARCO B85 PA110929-8 93 8 0 Rejected 5.000GILBARCO B85 PA110931-9 87 9 0 Approved 5.000GILBARCO B85 PA110931-9 89 9 0 Approved 5.000GILBARCO B85 PA110931-9 93 9 0 Approved 5.000GILBARCO B85 PA110931-10 87 10 0 Approved 5.000GILBARCO B85 PA110931-10 89 10 0 Approved 5.000GILBARCO B85 PA110931-10 93 10 0 Approved 5.000GILBARCO B85 PA110928--11 87 11 0 Not Tested 0.000GILBARCO B85 PA110928--11 89 11 0 Not Tested 0.000GILBARCO B85 PA110928--11 93 11 0 Not Tested 0.000GILBARCO B85 PA110928-12 87 12 0 Not Tested 0.000GILBARCO B85 PA110928-12 89 12 0 Not Tested 0.000GILBARCO B85 PA110928-12 93 12 0 Not Tested 0.000 GILBARCO RAC5921A RNO10487-13 Diesel 13 0 Approved 0.000 GILBARCO RAC5921A RN010487-14 Diesel 14 0 Approved 5.000
Device Product Used: 125. Insp Product Used: . Tot Product Used: 125.Grade Prod Used87 40.0089 40.0093 40.00Diesel 5.00
Billing Address:
,
Notes:
7&8 MISSING 10% ETHANOL LABEL
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 139 of 466
Inspector Acknowledged Receipt: SUKHJINDER SINGH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 140 of 466
Inspector Acknowledged Receipt: SUKHJINDER SINGH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/5/2011 Business ID: 00110505 Inspection: AU001103Business: A & R FOOD MART Store #: #16
3990 E WILLIAMSBURG RD Phone: Inspector: 325 MIKE TILLMAN
SANDSTON, VA 23150 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 32 32Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B7932G- PA127979-1 87 1 0 Approved 5.000GILBARCO B7932G- PA127979-1 89 1 0 Approved 5.000GILBARCO B7932G- PA127979-1 93 1 0 Approved 5.000GILBARCO B7932G- PA127979-2 87 2 0 Approved 5.000GILBARCO B7932G- PA127979-2 89 2 0 Approved 5.000GILBARCO B7932G- PA127981-3 89 3 0 Approved 5.000GILBARCO B7932G- PA127979-2 93 2 0 Approved 5.000GILBARCO B7932G- PA127980-5 87 5 0 Approved 5.000GILBARCO B7932G- PA127980-5 89 5 0 Approved 5.000GILBARCO B7932G- PA127981-3 87 3 0 Approved 5.000GILBARCO B7932G- PA127980-6 87 6 0 Approved 5.000GILBARCO B7932G- PA127980-6 89 6 0 Approved 5.000GILBARCO B7932G- PA127981-3 93 3 0 Approved 5.000GILBARCO B7932G- PA127981-4 87 4 0 Approved 5.000GILBARCO B7932G- PA127982-7 93 7 0 Approved 5.000GILBARCO B7932G- PA127981-4 89 4 0 Approved 5.000GILBARCO B7932G- PA127982-8 87 8 0 Approved 5.000GILBARCO B7932G- PA127981-4 93 4 0 Approved 5.000GILBARCO B7932G- PA127982-8 89 8 0 Approved 5.000GILBARCO B7C32G PA127968-10 87 10 0 Approved 5.000
Page 141 of 466
Inspector Acknowledged Receipt: RIZWAN ALIDOST
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B7C32G PA127968-10 89 10 0 Approved 5.000GILBARCO B7932G- PA127980-5 93 5 0 Approved 5.000GILBARCO B7C32G PA127968-9 89 9 0 Approved 5.000GILBARCO B7932G- PA127980-6 93 6 0 Approved 5.000GILBARCO B7932G- PA127982-7 87 7 0 Approved 5.000GILBARCO B7932G- PA127982-7 89 7 0 Approved 5.000GILBARCO B7932G- PA127982-8 93 8 0 Approved 5.000GILBARCO B7C32G PA127968-9 87 9 0 Approved 5.000GILBARCO B7C32G PA127968-9 93 9 0 Approved 5.000GILBARCO B7C32G PA127968-9 Diesel 9 0 Approved 5.000GILBARCO B7C32G PA127968-10 93 10 0 Approved 5.000GILBARCO B7C32G PA127968-10 Diesel 10 0 Approved 5.000
Device Product Used: 160. Insp Product Used: . Tot Product Used: 160.Grade Prod Used87 50.0089 50.0093 50.00Diesel 10.00
Billing Address:
,
Notes:
Page 142 of 466
Inspector Acknowledged Receipt: RIZWAN ALIDOST
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/5/2011 Business ID: 00112066 Inspection: AU001104Business: MILLER MART BP Store #:
11520 W BROAD ST Phone: (804)364-2495Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
04/05/11 02:00 PM 02:31 PM 0:31 0:00 0:31 C-8623 NO PROBLEM FOUNDTotal: 0:31 0:00 0:31
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H426B- 032407-6 87 6 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 143 of 466
Inspector Acknowledged Receipt: VIJAY SHAH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/7/2011 Business ID: 00501046 Inspection: AU001107Business: JAMES RIVER PETRO CARD Store #:
2216 CHARLES CITY RD Phone: 804-358-9000Inspector: 325 MIKE TILLMAN
RICHMOND, VA Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 6 6
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 3/G7242D/2GH 78821B-1 87 1 0 Approved 5.000WAYNE 3/G7242D/2GH 78821B-2 87 2 0 Approved 5.000WAYNE 3/G7203D/28G 78822B Diesel 3 0 Approved 5.000WAYNE 3/G7203D/28G 78822B Off Road Diesel 4 0 Approved 5.000WAYNE 3/G7237D/GHJ 78824B Diesel 5 0 Approved 5.000WAYNE 3/G7237D/GHJ 78823B Diesel 6 0 Approved 5.000
Device Product Used: 30. Insp Product Used: . Tot Product Used: 30.Grade Prod Used87 10.00Diesel 15.00Off Road Dies 5.00
Billing Address:
,
Notes:
Page 144 of 466
Inspector Acknowledged Receipt: MIKE GOFF
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/7/2011 Business ID: 00163047 Inspection: AU001108Business: WOODFIN WATCHCARD Store #:
4901 WILLIAMSBURG RD Phone: (804)730-4500Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 7 7
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GASBOY 9152AXTW2 C MNG0008197-1 87 1 0 Approved 5.000GASBOY 9153ATW1-CX MNG0001941 Diesel 7 0 Approved 5.000GASBOY 9152ATXW1 C MNGOOO8197-2 87 2 0 Approved 5.000GASBOY 785RCPR 01978553278 Off Road Diesel 3 0 Approved 5.000GASBOY 9152ATXW1 C MNGOO3198-4 87 4 0 Approved 5.000GASBOY 9152ATXW1 C MN0003198-5 87 5 0 Approved 5.000GASBOY 9153ATW1-CX 501362-8 Diesel 8 0 Approved 5.000GASBOY 9153ATW1-CX 501362-8 Diesel 8 0 Approved 5.000
Device Product Used: 40. Insp Product Used: . Tot Product Used: 40.Grade Prod Used87 20.00Diesel 15.00Off Road Dies 5.00
Billing Address:
,
Page 145 of 466
Inspector Acknowledged Receipt: BYRON LATTER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Notes:
Page 146 of 466
Inspector Acknowledged Receipt: BYRON LATTER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/7/2011 Business ID: 00188293 Inspection: AU001109Business: SUPER STOP Store #:
2610 DARBYTOWN ROAD Phone: 804-222-4310Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 24 24Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 1/V58004/G 724227-1 87 1 0 Approved 5.000WAYNE 1/V58004/G 724227-1 89 1 0 Approved 5.000WAYNE 1/V58004/G 724227-1 93 1 0 Approved 5.000WAYNE 1/V58004/G 724227-2 87 2 0 Approved 5.000WAYNE 1/V58004/G 724227-2 89 2 0 Approved 5.000WAYNE 1/V58004/G 724227-2 93 2 0 Approved 5.000WAYNE 1/V58004/G 724228-3 87 3 0 Approved 5.000WAYNE 1/V58004/G 724228-3 89 3 0 Approved 5.000WAYNE 1/V58004/G 724228-3 93 3 0 Approved 5.000WAYNE 1/V58004/G 724228-4 87 4 0 Approved 5.000WAYNE 1/V58004/G 724228-4 89 4 0 Approved 5.000WAYNE 1/V58004/G 724228-4 93 4 0 Approved 5.000WAYNE 1/V58004/G 724226-5 87 5 0 Approved 5.000WAYNE 1/V58004/G 724226-5 89 5 0 Approved 5.000WAYNE 1/V58004/G 724226-5 93 5 0 Approved 5.000WAYNE 1/V58004/G 724226-6 87 6 0 Approved 5.000WAYNE 1/V58004/G 724226-6 89 6 0 Approved 5.000WAYNE 1/V58004/G 724226-6 93 6 0 Approved 5.000WAYNE 1/V58004/G 724225-7 87 7 0 Approved 5.000WAYNE 1/V58004/G 724225-7 89 7 0 Approved 5.000
Page 147 of 466
Inspector Acknowledged Receipt: ODAI AKAILLEH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 1/V58004/G 724225-7 93 7 0 Approved 5.000WAYNE 1/V58004/G 724225-8 87 8 0 Approved 5.000WAYNE 1/V58004/G 724225-8 89 8 0 Approved 5.000WAYNE 1/V58004/G 724225-8 93 8 0 Approved 5.000
Device Product Used: 120. Insp Product Used: . Tot Product Used: 120.Grade Prod Used87 40.0089 40.0093 40.00
Billing Address:
,
Notes:
Page 148 of 466
Inspector Acknowledged Receipt: ODAI AKAILLEH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/8/2011 Business ID: 00163589 Inspection: AU001113Business: ROYAL MART Store #: #7
8920 W BROAD ST Phone: (804)346-9293Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
04/08/11 11:07 AM 11:33 AM 0:26 0:00 0:26 C-8640 NO PRPBLEM FOUNDTotal: 0:26 0:00 0:26
Class Actv App Rej Con CwC NTLiquid Measuring Device 3 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NGO 177621-8 87 4 0 Approved 0.000GILBARCO NGO 177621-8 89 4 0 Approved 0.000GILBARCO NGO 177621-8 93 4 0 Approved 0.000
Billing Address:
,
Notes:
Page 149 of 466
Inspector Acknowledged Receipt: DENNS KAMAU
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/14/2011 Business ID: 00113956 Inspection: AU001124Business: 7-ELEVEN Store #: #32603
11480 W BROAD ST Phone: 804-364-4108Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
04/14/11 07:50 AM 08:15 AM 0:25 0:00 0:25 C-8655Total: 0:25 0:00 0:25
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO 7B30 PA18024-9 89 9 0 Condemned 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used89 5.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 150 of 466
Inspector Acknowledged Receipt: SURESH BAU
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 151 of 466
Inspector Acknowledged Receipt: SURESH BAU
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/18/2011 Business ID: 00113700 Inspection: AU001130Business: FAS MART Store #: #52
4001 E WILLIAMSBURG RD Phone: (804)737-1300Inspector: 325 MIKE TILLMAN
SANDSTON, VA 23150 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE X1/V590D4/GJ 713378-4 89 4 0 Approved 1.000
Device Product Used: 1. Insp Product Used: . Tot Product Used: 1.Grade Prod Used89 1.00
Billing Address:
,
Notes:
Page 152 of 466
Inspector Acknowledged Receipt: NORMA CAHOON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/18/2011 Business ID: 00021432 Inspection: AU001131Business: PUMP MART CONVENIENCE EXXON Store #:
10504 PATTERSON AVE Phone: (804)741-7562Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
04/18/11 01:00 PM 01:28 PM 0:28 0:00 0:28 C-8663 NO PROBLEM FOUNDTotal: 0:28 0:00 0:28
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H426B- PMP06843-3 87 3 -1 Approved 1.000
Device Product Used: 1. Insp Product Used: . Tot Product Used: 1.Grade Prod Used87 1.00
Billing Address:
,
Notes:
Page 153 of 466
Inspector Acknowledged Receipt: JACK PATEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/18/2011 Business ID: 00500737 Inspection: AU001133Business: UPPYS # 28 Store #: #28
3101 LAUDERDALE DR Phone: 804-360-0269Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 3 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 GSEN130313-7 87 7 0 Approved 5.000GILBARCO NN1 GSEN130313-7 89 7 0 Approved 5.000GILBARCO NN1 GSEN130313-7 93 7 0 Approved 5.000
Device Product Used: 15. Insp Product Used: . Tot Product Used: 15.Grade Prod Used87 5.0089 5.0093 5.00
Billing Address:
,
Notes:
Page 154 of 466
Inspector Acknowledged Receipt: DAVID ADDINGTON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/20/2011 Business ID: 00110848 Inspection: AU001143Business: HESS Store #: 46504
3801 MECHANICSVILLE TNPK Phone: 804-329-3921Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
04/20/11 03:19 PM 03:34 PM 0:15 0:00 0:15 C-8674 TAKEN OUT OF SERVICE FOR REPAIRTotal: 0:15 0:00 0:15
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE V387D1/GQY 648496-13 Diesel 13 -1 Condemned 1.000
Device Product Used: 1. Insp Product Used: . Tot Product Used: 1.Grade Prod UsedDiesel 1.00
Billing Address:
,
Notes:
ABNORMAL PERFORMANCE ON NOZZLE LEAKING AUTO SHUTOFF
Page 155 of 466
Inspector Acknowledged Receipt: FAYE BRANDANBERGER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Page 156 of 466
Inspector Acknowledged Receipt: FAYE BRANDANBERGER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 157 of 466
Inspector Acknowledged Receipt: FAYE BRANDANBERGER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/28/2011 Business ID: 00500740 Inspection: AU001149Business: 7 - EIEVEN #34015 Store #: #34015
9500 W. BROAD ST Phone: 804-270-4345Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23294 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
04/28/11 01:38 PM 01:58 PM 0:20 0:00 0:20 C-8694 METER CREEPINGTotal: 0:20 0:00 0:20
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 KTEN156042-6 93 6 -2 Condemned 2.000
Device Product Used: 2. Insp Product Used: . Tot Product Used: 2.Grade Prod Used93 2.00
Billing Address:
,
Notes:
METER CREEPING WHILE FUELING
Page 158 of 466
Inspector Acknowledged Receipt: AKMAL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Page 159 of 466
Inspector Acknowledged Receipt: AKMAL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 160 of 466
Inspector Acknowledged Receipt: AKMAL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 4/29/2011 Business ID: 00110848 Inspection: AU001150Business: HESS Store #: 46504
3801 MECHANICSVILLE TNPK Phone: 804-329-3921Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE V387D1/GQY 648496-13 Diesel 13 0 Approved 1.000
Device Product Used: 1. Insp Product Used: . Tot Product Used: 1.Grade Prod UsedDiesel 1.00
Billing Address:
,
Notes:
Page 161 of 466
Inspector Acknowledged Receipt: NURUL KHALIFA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 5/4/2011 Business ID: 00113956 Inspection: AU001161Business: 7-ELEVEN Store #: #32603
11480 W BROAD ST Phone: 804-364-4108Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO 7B30 PA18024-9 89 9 -1 Approved 1.000
Device Product Used: 1. Insp Product Used: . Tot Product Used: 1.Grade Prod Used89 1.00
Billing Address:
,
Notes:
Page 162 of 466
Inspector Acknowledged Receipt: SURESH BABU
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 5/4/2011 Business ID: 00111765 Inspection: AU001163Business: ZOTAS CITGO Store #: #662
7834 PARHAM RD Phone: (804)747-6090Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA094306-2 87 2 -1 Approved 1.000
Device Product Used: 1. Insp Product Used: . Tot Product Used: 1.Grade Prod Used87 1.00
Billing Address:
,
Notes:
Page 163 of 466
Inspector Acknowledged Receipt: SYFYL ALAMB
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 5/4/2011 Business ID: 00113715 Inspection: AU001164Business: WOODMAN FOOD MART Store #:
9024 WOODMAN RD Phone: (804)266-9241Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Reinspection 3
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B65 PA024145-1 93 1 -1 Approved 1.000
Device Product Used: 1. Insp Product Used: . Tot Product Used: 1.Grade Prod Used93 1.00
Billing Address:
,
Notes:
Page 164 of 466
Inspector Acknowledged Receipt: NOORJEHAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 5/4/2011 Business ID: 00271875 Inspection: AU001167Business: WAWA Store #: #655
5231 BROOK RD Phone: (804)266-1031Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23227 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
05/04/11 01:25 PM 01:55 PM 0:30 0:00 0:30 C-8711 NO PROBLEM WAS FOUNDTotal: 0:30 0:00 0:30
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 BREN088456-7 87 7 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 165 of 466
Inspector Acknowledged Receipt: JERRMY KERDER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 5/4/2011 Business ID: 00193554 Inspection: AU001168Business: FAS MART Store #: #80
5101 RICH-HENRICO TNPK Phone: 804-329-1734Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23227 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B65 PA053768-8 93 8 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used93 5.00
Billing Address:
,
Notes:
Page 166 of 466
Inspector Acknowledged Receipt: CALVIN HARRELL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 5/25/2011 Business ID: 00112830 Inspection: AU001205Business: STAPLES MILL SUNOCO Store #: #475
8701 STAPLES MILL RD Phone: 804-264-8701bInspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
05/25/11 02:00 PM 02:25 PM 0:25 0:00 0:25 C-8760 LEAKING HOSETotal: 0:25 0:00 0:25
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE DL1-361-IL 570156 Diesel D-3 0 Condemned 0.000
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 167 of 466
Inspector Acknowledged Receipt: SULTAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 168 of 466
Inspector Acknowledged Receipt: SULTAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/7/2011 Business ID: 00112856 Inspection: AU001216Business: ONE STOP MART BP Store #: #1
1301 N LABURNUM AVE Phone: (804)649-8700Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
06/07/11 09:35 AM 09:48 AM 0:13 0:00 0:13 C-8788 CARD NOT WORKINGTotal: 0:13 0:00 0:13
Class Actv App Rej Con CwC NTLiquid Measuring Device 6 6
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B85 PA110931-9 87 9 0 Rejected 0.000GILBARCO B85 PA110931-9 89 9 0 Rejected 0.000GILBARCO B85 PA110931-9 93 9 0 Rejected 0.000GILBARCO B85 PA110931-10 87 10 0 Rejected 0.000GILBARCO B85 PA110931-10 89 10 0 Rejected 0.000GILBARCO B85 PA110931-10 93 10 0 Rejected 0.000
Billing Address:
,
Notes:
Page 169 of 466
Inspector Acknowledged Receipt:
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Page 170 of 466
Inspector Acknowledged Receipt:
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 171 of 466
Inspector Acknowledged Receipt:
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/7/2011 Business ID: 00112856 Inspection: AU001217Business: ONE STOP MART BP Store #: #1
1301 N LABURNUM AVE Phone: (804)649-8700Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 6 6
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B85 PA110929-7 87 7 0 Approved 0.000GILBARCO B85 PA110929-7 89 7 0 Approved 0.000GILBARCO B85 PA110929-7 93 7 0 Approved 0.000GILBARCO B85 PA110929-8 87 8 0 Approved 0.000GILBARCO B85 PA110929-8 89 8 0 Approved 0.000GILBARCO B85 PA110929-8 93 8 0 Approved 0.000
Billing Address:
,
Notes:
Page 172 of 466
Inspector Acknowledged Receipt:
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/8/2011 Business ID: 00161717 Inspection: AU001220Business: AIRPORT EXXON UPPYS # 40 Store #: #26558
4710 WILLIAMSBURG RD Phone: 804-236-0021Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 38 38Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 BSEN121601-1 87 1 0 Approved 5.000GILBARCO NN1 BSEN121601-1 89 1 0 Approved 5.000GILBARCO NN1 BSEN121601-2 87 2 0 Approved 5.000GILBARCO NN1 BSEN121602-9 87 9 0 Approved 5.000GILBARCO NN1 BSEN121601-1 93 1 0 Approved 5.000GILBARCO NN1 BSEN121601-2 89 2 0 Approved 5.000GILBARCO NN1 BSEN121601-2 93 2 0 Approved 5.000GILBARCO NN1 BSEN121608-3 87 3 0 Approved 5.000GILBARCO NN1 BSEN121608-3 89 3 0 Approved 5.000GILBARCO NN1 BSEN121608-3 93 3 0 Approved 5.000GILBARCO NN1 BSEN121608-4 87 4 0 Approved 5.000GILBARCO NN1 BSEN121608-4 89 4 0 Approved 5.000GILBARCO NN1 BSEN121608-4 93 4 0 Approved 5.000GILBARCO NN1 BSEN121603-5 87 5 0 Approved 5.000GILBARCO NN1 BSEN121603-5 89 5 0 Approved 5.000GILBARCO NN1 BSEN121603-5 93 5 0 Approved 5.000GILBARCO NN1 BSEN121603-6 87 6 0 Approved 5.000GILBARCO NN1 BSEN121603-6 89 6 0 Approved 5.000GILBARCO NN1 BSEN121603-6 93 6 0 Approved 5.000GILBARCO NN1 BSEN121600-7 87 7 0 Approved 5.000
Page 173 of 466
Inspector Acknowledged Receipt: STEPHANIE GREENMAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 BSEN121600-7 89 7 0 Approved 5.000GILBARCO NN1 BSEN121600-7 93 7 0 Approved 5.000GILBARCO NN1 BSEN121600-8 87 8 0 Approved 5.000GILBARCO NN1 BSEN121600-8 89 8 0 Approved 5.000GILBARCO NN1 BSEN121600-8 93 8 0 Approved 5.000GILBARCO NN1 BSEN121602-9 89 9 0 Approved 5.000GILBARCO NN1 BSEN121602-9 93 9 0 Approved 5.000GILBARCO NN1 BSEN121602-10 87 10 0 Approved 5.000GILBARCO NN1 BSEN121602-10 89 10 0 Approved 5.000GILBARCO NN1 BSEN121602-10 93 10 0 Approved 5.000GILBARCO NL1 BSEN121605-11 87 11 0 Approved 5.000GILBARCO NL1 BSEN121605-11 89 11 0 Approved 5.000GILBARCO NL1 BSEN121605-11 93 11 0 Approved 5.000GILBARCO NL1 BSEN121605-11 Diesel 11 0 Approved 5.000GILBARCO NL1 BSEN121605-12 87 12 0 Approved 5.000GILBARCO NL1 BSEN121605-12 89 12 0 Approved 5.000GILBARCO NL1 BSEN121605-12 93 12 0 Approved 5.000GILBARCO NL1 BSEN121605-12 Diesel 12 0 Approved 5.000
Device Product Used: 190. Insp Product Used: . Tot Product Used: 190.Grade Prod Used87 60.0089 60.0093 60.00Diesel 10.00
Billing Address:
,
Notes:
Page 174 of 466
Inspector Acknowledged Receipt: STEPHANIE GREENMAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/10/2011 Business ID: 00113653 Inspection: AU001227Business: FAS MART Store #: #84
601-A AIRPORT DR Phone: (804)328-1322Inspector: 325 MIKE TILLMAN
HIGHLAND SPRINGS, VA 23075 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 18 18Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 094010-1 87 1 0 Approved 5.000GILBARCO B79 094010-1 89 1 0 Approved 5.000GILBARCO B79 094010-1 93 1 0 Approved 5.000GILBARCO B79 094010-2 87 2 0 Approved 5.000GILBARCO B79 094010-2 89 2 0 Approved 5.000GILBARCO B79 094010-2 93 2 0 Approved 5.000GILBARCO B79 094012-3 87 3 0 Approved 5.000GILBARCO B79 094012-3 89 3 0 Approved 5.000GILBARCO B79 094012-3 93 3 0 Approved 5.000GILBARCO B79 094012-4 87 4 0 Approved 5.000GILBARCO B79 094012-4 89 4 0 Approved 5.000GILBARCO B79 094012-4 93 4 0 Approved 5.000GILBARCO B79 094011-5 87 5 0 Approved 5.000GILBARCO B79 094011-5 89 5 0 Approved 5.000GILBARCO B79 094011-5 93 5 0 Approved 5.000GILBARCO B79 094011-6 87 6 0 Approved 5.000GILBARCO B79 094011-6 89 6 0 Approved 5.000GILBARCO B79 094011-6 93 6 0 Approved 5.000
Device Product Used: 90. Insp Product Used: . Tot Product Used: 90.
Page 175 of 466
Inspector Acknowledged Receipt: A BEATY
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Grade Prod Used87 30.0089 30.0093 30.00
Billing Address:
,
Notes:
Page 176 of 466
Inspector Acknowledged Receipt: A BEATY
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/10/2011 Business ID: 00114076 Inspection: AU001228Business: 7-ELEVEN Store #: #11092
389 E WILLIAMSBURG RD Phone: (757)490-6338Inspector: 325 MIKE TILLMAN
SANDSTON, VA 23150 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 12 12Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO RD5304 -7-11 RM024501-3 87 3 0 Approved 5.000GILBARCO BO5004 PAD12496-1 87 1 0 Approved 5.000GILBARCO BO5004 PAD12496-1 89 1 0 Approved 5.000GILBARCO BO5004 PAD12496-1 93 1 0 Approved 5.000GILBARCO BO5004 PAD12496-2 87 2 0 Approved 5.000GILBARCO BO5004 PAD12496-2 89 2 0 Approved 5.000GILBARCO BO5004 PAD12496-2 93 2 0 Approved 5.000GILBARCO RD5304 -7-11 RM024501-3 89 3 0 Approved 5.000GILBARCO RD5304 -7-11 RM024501-3 93 3 0 Approved 5.000GILBARCO RD5304 -7-11 RM024501-4 87 4 0 Approved 5.000GILBARCO RD5304 -7-11 RM024501-4 89 4 0 Approved 5.000GILBARCO RD5304 -7-11 RM024501-4 93 4 0 Approved 5.000
Device Product Used: 60. Insp Product Used: . Tot Product Used: 60.Grade Prod Used87 20.0089 20.0093 20.00
Page 177 of 466
Inspector Acknowledged Receipt: kIM vIA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Billing Address:
,
Notes:
AD SIGN MISSING 9/10 REG.
Page 178 of 466
Inspector Acknowledged Receipt: kIM vIA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/10/2011 Business ID: 00021050 Inspection: AU001229Business: VARINA MARKET Store #:
4110 DARBYTOWN RD Phone: 804-795-7892Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 20 10 10Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B85 PA202186-1 87 1 4 Approved 5.000GILBARCO B85 PA202186-1 89 1 -12 Rejected 10.000GILBARCO B85 PA202186-1 93 1 4 Approved 5.000GILBARCO B85 PA202186-1 Diesel 1 6 Approved 5.000GILBARCO B85 PA202186-2 87 2 4 Approved 5.000GILBARCO B85 PA202186-2 89 2 4 Approved 5.000GILBARCO B85 PA202186-2 93 2 4 Approved 5.000GILBARCO B85 PA202186-2 Diesel 2 12 Rejected 5.000GILBARCO B79 PA174519-3 87 3 2 Approved 5.000GILBARCO B79 PA174519-3 89 3 3 Approved 5.000GILBARCO B79 PA174519-3 93 3 4 Approved 5.000GILBARCO B79 PA174519-4 87 4 3 Approved 5.000GILBARCO B79 PA174519-4 89 4 0 Rejected 2.000GILBARCO B79 PA174519-4 93 4 3 Rejected 1.000GILBARCO B79 PA174520-5 87 5 7 Rejected 5.000GILBARCO B79 PA174520-5 89 5 7 Rejected 5.000GILBARCO B79 PA174520-5 93 5 8 Rejected 5.000GILBARCO B79 PA174520-6 87 6 8 Rejected 5.000GILBARCO B79 PA174520-6 89 6 7 Rejected 5.000GILBARCO B79 PA174520-6 93 6 7 Rejected 5.000
Page 179 of 466
Inspector Acknowledged Receipt: DINA GANDHI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Device Product Used: 98. Insp Product Used: . Tot Product Used: 98.Grade Prod Used87 30.0089 32.0093 26.00Diesel 10.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above
Page 180 of 466
Inspector Acknowledged Receipt: DINA GANDHI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 181 of 466
Inspector Acknowledged Receipt: DINA GANDHI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/13/2011 Business ID: 00500712 Inspection: AU001230Business: SAMS CLUB #4788 Store #: 4788
4571 S LABURNMUM Phone: 804-222-5208Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 28 25 3Gas Station 1 1Small Capacity Scale 4 4
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B12 47802B-10 87 10 0 Approved 5.000WAYNE B23 47806B-1 87 1 0 Approved 5.000WAYNE B23 47806B-1 93 1 0 Approved 5.000WAYNE B23 47806B-1 Diesel 1 0 Approved 5.000WAYNE B23 47806B-2 87 2 0 Approved 5.000WAYNE B23 47806B-2 93 2 0 Approved 5.000WAYNE B23 47806B-2 Diesel 2 20 Rejected 5.000WAYNE B23 47807B-7 87 7 0 Approved 5.000WAYNE B23 47807B-7 93 7 0 Approved 5.000WAYNE B23 47807B-7 Diesel 7 -7 Rejected 5.000WAYNE B23 47807B-8 87 8 0 Approved 5.000WAYNE B23 47807B-8 93 8 0 Approved 5.000WAYNE B23 47807B-8 Diesel 8 0 Approved 5.000WAYNE B12 47803B-3 87 3 0 Approved 5.000WAYNE B12 47803B-3 93 3 0 Approved 5.000WAYNE B12 47803B-4 87 4 0 Approved 5.000WAYNE B12 47803B-4 93 4 0 Approved 5.000WAYNE B12 47804B-5 87 5 0 Approved 5.000WAYNE B12 47804B-5 93 5 0 Approved 5.000
Page 182 of 466
Inspector Acknowledged Receipt: BRIAN SIMPSON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B12 47804B-6 87 6 0 Approved 5.000WAYNE B12 47804B-6 93 6 0 Approved 5.000WAYNE B12 47802B-9 87 9 0 Approved 5.000WAYNE B12 47802B-9 93 9 0 Approved 5.000WAYNE B12 47802B-10 93 10 0 Approved 5.000WAYNE B12 47805B-11 87 11 0 Approved 5.000WAYNE B12 47805B-11 93 11 0 Approved 5.000WAYNE B12 47805B-12 87 12 9 Rejected 10.000WAYNE B12 47805B-12 93 12 0 Approved 5.000
Device Product Used: 145. Insp Product Used: . Tot Product Used: 145.Grade Prod Used87 65.0093 60.00Diesel 20.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANS
Page 183 of 466
Inspector Acknowledged Receipt: BRIAN SIMPSON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Service Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 184 of 466
Inspector Acknowledged Receipt: BRIAN SIMPSON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/13/2011 Business ID: 00110988 Inspection: AU001231Business: KROGER Store #: #502
4816 S LABURNUM AVE Phone: (804)222-0240Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 36 36Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B12 84175B K10B-9 87 9 0 Approved 5.000WAYNE B12 84175B K10B-9 89 9 0 Approved 5.000WAYNE B12 84175B K10B-9 93 9 0 Approved 5.000WAYNE B12 84175B K10B-10 87 10 0 Approved 5.000WAYNE B12 84175B K10B-10 89 10 0 Approved 5.000WAYNE B12 84175B K10B-10 93 10 0 Approved 5.000WAYNE B12 83306B J10-7 87 7 0 Approved 5.000WAYNE B12 83306B J10-7 89 7 0 Approved 5.000WAYNE B12 83306B J10-7 93 7 0 Approved 5.000WAYNE B12 83306B J10-8 87 8 0 Approved 5.000WAYNE B12 83306B J10-8 89 8 0 Approved 5.000WAYNE B12 83306B J10-8 93 8 0 Approved 5.000WAYNE B23 83303B J10-1 87 1 0 Approved 5.000WAYNE B23 83303B J10-1 89 1 0 Approved 5.000WAYNE B23 83303B J10-1 93 1 0 Approved 5.000WAYNE B23 83303B J10-1 Diesel 1 0 Approved 5.000WAYNE B23 83303B J10-2 87 2 0 Approved 5.000WAYNE B23 83303B J10-2 89 2 0 Approved 5.000WAYNE B23 83303B J10-2 93 2 0 Approved 5.000WAYNE B23 83303B J10-2 Diesel 2 0 Approved 5.000
Page 185 of 466
Inspector Acknowledged Receipt: CORY WILSON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B23 83304B J10-3 87 3 0 Approved 5.000WAYNE B23 83304B J10-3 89 3 0 Approved 5.000WAYNE B23 83304B J10-3 93 3 0 Approved 5.000WAYNE B23 83304B J10-3 Diesel 3 0 Approved 5.000WAYNE B23 83304B-J10-4 87 4 0 Approved 5.000WAYNE B23 83304B-J10-4 89 4 0 Approved 5.000WAYNE B23 83304B-J10-4 93 4 0 Approved 5.000WAYNE B23 83304B-J10-4 Diesel 4 0 Approved 5.000WAYNE B23 84176B K10-5 87 5 0 Approved 5.000WAYNE B23 84176B K10-5 89 5 0 Approved 5.000WAYNE B23 84176B K10-5 93 5 0 Approved 5.000WAYNE B23 84176B K10-5 Diesel 5 0 Approved 5.000WAYNE B23 84176B K10-6 87 6 0 Approved 5.000WAYNE B23 84176B K10-6 89 6 0 Approved 5.000WAYNE B23 84176B K10-6 93 6 0 Approved 5.000WAYNE B23 84176B K10-6 Diesel 6 0 Approved 5.000
Device Product Used: 180. Insp Product Used: . Tot Product Used: 180.Grade Prod Used87 50.0089 50.0093 50.00Diesel 30.00
Billing Address:
,
Notes:
Page 186 of 466
Inspector Acknowledged Receipt: CORY WILSON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/15/2011 Business ID: 00271875 Inspection: AU001235Business: WAWA Store #: #655
5231 BROOK RD Phone: (804)266-1031Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23227 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 48 48Gas Station 1 1Small Capacity Scale 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 BREN088456-7 87 7 0 Approved 5.000GILBARCO NN1 BREN088461-1 87 1 0 Approved 5.000GILBARCO NN1 BREN088461-2 87 2 0 Approved 5.000GILBARCO NN1 BREN088461-1 89 1 0 Approved 5.000GILBARCO NN1 BREN088461-1 92 1 0 Approved 5.000GILBARCO NN1 BREN088461-2 89 2 0 Approved 5.000GILBARCO NN1 BREN088461-2 92 2 0 Approved 5.000GILBARCO NN1 BREN088458-3 87 3 0 Approved 5.000GILBARCO NN1 BREN088458-3 89 3 0 Approved 5.000GILBARCO NN1 BREN088458-3 92 3 0 Approved 5.000GILBARCO NN1 BREN088458-4 87 4 0 Approved 5.000GILBARCO NN1 BREN088458-4 89 4 0 Approved 5.000GILBARCO NN1 BREN088458-4 92 4 0 Approved 5.000GILBARCO NN1 BREN088460-5 87 5 0 Approved 5.000GILBARCO NN1 BREN088460-5 89 5 0 Approved 5.000GILBARCO NN1 BREN088460-5 92 5 0 Approved 5.000GILBARCO NN1 BREN088460-6 87 6 0 Approved 5.000GILBARCO NN1 BREN088460-6 89 6 0 Approved 5.000GILBARCO NN1 BREN088460-6 92 6 0 Approved 5.000
Page 187 of 466
Inspector Acknowledged Receipt: jEREMY kERBER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 BREN088456-7 89 7 0 Approved 5.000GILBARCO NN1 BREN088456-7 92 7 0 Approved 5.000GILBARCO NN1 BREN088456-8 87 8 0 Approved 5.000GILBARCO NN1 BREN088456-8 89 8 0 Approved 5.000GILBARCO NN1 BREN088456-8 92 8 0 Approved 5.000GILBARCO NN1 BREN088459-9 87 9 0 Approved 5.000GILBARCO NN1 BREN088459-9 89 9 0 Approved 5.000GILBARCO NN1 BREN088459-9 92 9 0 Approved 5.000GILBARCO NN1 BREN088459-10 87 10 0 Approved 5.000GILBARCO NN1 BREN088459-10 89 10 0 Approved 5.000GILBARCO NN1 BREN088459-10 92 10 0 Approved 5.000GILBARCO NN1 BREN088457-11 87 11 0 Approved 5.000GILBARCO NN1 BREN088457-11 89 11 0 Approved 5.000GILBARCO NN1 BREN088457-11 92 11 0 Approved 5.000GILBARCO NN1 BREN088457-12 87 12 0 Approved 5.000GILBARCO NN1 BREN088457-12 89 12 0 Approved 5.000GILBARCO NN1 BREN088457-12 92 12 0 Approved 5.000GILBARCO NN1 BREN088462-13 87 13 0 Approved 5.000GILBARCO NN1 BREN088462-13 89 13 0 Approved 5.000GILBARCO NN1 BREN088462-13 92 13 0 Approved 5.000GILBARCO NN1 BREN088462-14 87 14 0 Approved 5.000GILBARCO NN1 BREN088462-14 89 14 0 Approved 5.000GILBARCO NN1 BREN088462-14 92 14 0 Approved 5.000GILBARCO NN1 BREN088455-15 87 15 0 Approved 5.000GILBARCO NN1 BREN088455-15 89 15 0 Approved 5.000GILBARCO NN1 BREN088455-15 92 15 0 Approved 5.000GILBARCO NN1 BREN088455-16 87 15 0 Approved 5.000GILBARCO NN1 BREN088455-16 89 15 0 Approved 5.000GILBARCO NN1 BREN088455-16 92 15 0 Approved 5.000
Device Product Used: 240. Insp Product Used: . Tot Product Used: 240.Grade Prod Used87 80.0089 80.0092 80.00
Page 188 of 466
Inspector Acknowledged Receipt: jEREMY kERBER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Billing Address:
,
Notes:
Page 189 of 466
Inspector Acknowledged Receipt: jEREMY kERBER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/15/2011 Business ID: 00021685 Inspection: AU001236Business: LUCKYS Store #:
607 E LABURNUM AVE Phone: 804-329-9349Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23222 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 28 12 11 3 2Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B12/3223D1/JK 63005A-7 87 7 0 Approved 5.000WAYNE B12/3223D1/JK 63006A-1 87 1 0 Condemned 5.000WAYNE B12/3223D1/JK 63006A-1 89 1 0 Condemned 5.000WAYNE B12/3223D1/JK 63006A-1 93 1 0 Condemned 5.000WAYNE B12/3223D1/JK 63006A-2 87 2 0 Rejected 5.000WAYNE B12/3223D1/JK 63006A-2 89 2 0 Rejected 5.000WAYNE B12/3223D1/JK 63006A-2 93 2 0 Rejected 5.000WAYNE B12/3223D1/JK 63008A-3 87 3 0 Rejected 5.000WAYNE B12/3223D1/JK 63008A-3 89 3 0 Rejected 5.000WAYNE B12/3223D1/JK 63008A-3 93 3 0 Rejected 5.000WAYNE B12/3223D1/JK 63008A-4 87 4 0 Approved 5.000WAYNE B12/3223D1/JK 63008A-4 89 4 0 Approved 5.000WAYNE B12/3223D1/JK 63008A-4 93 4 0 Rejected 5.000WAYNE B12/3223D1/JK 63007A-5 87 5 0 Approved 5.000WAYNE B12/3223D1/JK 63007A-5 89 5 0 Approved 5.000WAYNE B12/3223D1/JK 63007A-5 93 5 0 Approved 5.000WAYNE B12/3223D1/JK 63007A-6 87 6 0 Approved 5.000WAYNE B12/3223D1/JK 63007A-6 89 6 0 Approved 5.000WAYNE B12/3223D1/JK 63007A-6 93 6 0 Approved 5.000WAYNE B12/3223D1/JK 63005A-7 89 7 0 Approved 5.000
Page 190 of 466
Inspector Acknowledged Receipt: OMAR LUQMAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B12/3223D1/JK 63005A-7 93 7 0 Approved 5.000WAYNE B12/3223D1/JK 63005A-8 87 8 0 Approved 5.000WAYNE B12/3223D1/JK 63005A-8 89 8 0 Rejected 5.000WAYNE B12/3223D1/JK 63005A-8 93 8 0 Rejected 5.000WAYNE R11-1220D1/J 63009A-9 Diesel 9 0 Rejected 5.000WAYNE R11-1220D1/J 63009A-10 Diesel 10 0 Rejected 5.000WAYNE 3/0220/GJK/ 99-122-11 Kerosene 11 0 Not Tested 5.000WAYNE 3/0220/GJK/ 99-122-12 Kerosene 12 0 Not Tested 5.000
Device Product Used: 140. Insp Product Used: . Tot Product Used: 140.Grade Prod Used87 40.0089 40.0093 40.00Diesel 10.00Kerosene 10.00
Billing Address:
,
Notes:
ALL BROKEN/CRACKED =PRICE PER GALLION NOT READABLE
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
Page 191 of 466
Inspector Acknowledged Receipt: OMAR LUQMAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 192 of 466
Inspector Acknowledged Receipt: OMAR LUQMAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/17/2011 Business ID: 00113723 Inspection: AU001243Business: ROY'S EXPRESS MART Store #:
7605 STAPLES MILL RD Phone: (804)266-0382Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 26 14 1 5 6Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE D359023gqy 608504-1 87 1 0 Approved 5.000WAYNE D359023gqy 608504-1 89 1 0 Approved 5.000WAYNE D359023gqy 608504-1 93 1 0 Approved 5.000WAYNE D359023gqy 608504-2 87 2 0 Approved 5.000WAYNE D359023gqy 608504-2 89 2 0 Rejected 5.000WAYNE D359023gqy 608504-2 93 2 0 Approved 5.000WAYNE D359023gqy 608510-3 87 3 0 Approved 5.000WAYNE D359023gqy 608510-3 89 3 -20 Condemned 5.000WAYNE D359023gqy 608510-3 93 3 -20 Condemned 5.000WAYNE D359023gqy 608510-4 87 4 0 Approved 5.000WAYNE D359023gqy 608510-4 89 4 0 Approved 5.000WAYNE D359023gqy 608510-4 93 4 -12 Condemned 5.000WAYNE D359023gqy 608513-5 87 5 0 Approved 5.000WAYNE D359023gqy 608513-5 89 5 0 Approved 5.000WAYNE D359023gqy 608513-5 93 5 0 Approved 5.000WAYNE D359023gqy 608513-6 87 6 -20 Condemned 5.000WAYNE D359023gqy 608513-6 89 6 -20 Condemned 5.000WAYNE D359023gqy 608513-6 93 6 0 Approved 5.000WAYNE D359023gqy 608514-7 87 7 0 Not Tested 0.000WAYNE D359023gqy 608514-7 89 7 0 Not Tested 0.000
Page 193 of 466
Inspector Acknowledged Receipt: ZARINA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE D359023gqy 608514-7 93 7 0 Not Tested 0.000WAYNE D359023gqy 608514-8 87 8 0 Not Tested 0.000WAYNE D359023gqy 608514-8 89 8 0 Not Tested 0.000WAYNE D359023gqy 608514-8 93 8 0 Not Tested 0.000WAYNE DL1363-1l19 49-9 Diesel 9 0 Approved 5.000WAYNE DL1363-1l19 49-10 Diesel 10 0 Approved 0.000
Device Product Used: 95. Insp Product Used: . Tot Product Used: 95.Grade Prod Used87 30.0089 30.0093 30.00Diesel 5.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled
Page 194 of 466
Inspector Acknowledged Receipt: ZARINA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
"Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 195 of 466
Inspector Acknowledged Receipt: ZARINA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/17/2011 Business ID: 00240624 Inspection: AU001244Business: RIDGEFIELD EXXON Store #:
10400 RIDGEFIELD PARKWAY Phone: (804)740-1990Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 28 28Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 pa171308-1 87 1 0 Approved 5.000GILBARCO B79 PA171308--2 87 2 0 Approved 5.000GILBARCO B7C PA171311-5 87 5 0 Approved 5.000GILBARCO B79 pa171308-1 89 1 0 Approved 5.000GILBARCO B79 PA171308--2 89 2 0 Approved 5.000GILBARCO B79 pa171308-1 93 1 0 Approved 5.000GILBARCO B79 PA171308--2 93 2 0 Approved 5.000GILBARCO B79 PA171309-3 87 3 0 Approved 5.000GILBARCO B79 PA171309-3 89 3 0 Approved 5.000GILBARCO B79 PA171309-3 93 3 0 Approved 5.000GILBARCO B79 PA171309-4 87 4 0 Approved 5.000GILBARCO B79 PA171309-4 89 4 0 Approved 5.000GILBARCO B79 PA171309-4 93 4 0 Approved 5.000GILBARCO B7C PA171311-5 89 5 0 Approved 5.000GILBARCO B7C PA171311-5 93 5 0 Approved 5.000GILBARCO B7C PA171311-5 Diesel 5 0 Approved 5.000GILBARCO B7C PA171311-6 87 6 0 Approved 5.000GILBARCO B7C PA171311-6 89 6 0 Approved 5.000GILBARCO B7C PA171311-6 93 6 0 Approved 5.000GILBARCO B7C PA171311-6 Diesel 6 0 Approved 5.000
Page 196 of 466
Inspector Acknowledged Receipt: RAFI ISLAM
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B7C PA171310-7 87 7 0 Approved 5.000GILBARCO B7C PA171310-7 89 7 0 Approved 5.000GILBARCO B7C PA171310-7 93 7 0 Approved 5.000GILBARCO B7C PA171310-7 Diesel 7 0 Approved 5.000GILBARCO B7C PA171310-8 87 8 0 Approved 5.000GILBARCO B7C PA171310-8 89 8 0 Approved 5.000GILBARCO B7C PA171310-8 93 8 0 Approved 5.000GILBARCO B7C PA171310-8 Diesel 8 0 Approved 5.000
Device Product Used: 140. Insp Product Used: . Tot Product Used: 140.Grade Prod Used87 40.0089 40.0093 40.00Diesel 20.00
Billing Address:
,
Notes:
Page 197 of 466
Inspector Acknowledged Receipt: RAFI ISLAM
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/21/2011 Business ID: 00111212 Inspection: AU001248Business: SANDSTON CHUBBYS Store #: #13
5710 WILLIAMSBURG RD Phone: 804-222-1760Inspector: 325 MIKE TILLMAN
SANDSTON, VA 23150 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 41 41Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 208525-1 87 1 0 Approved 5.000 GILBARCO NN1 208525-1 89 1 0 Approved 5.000 GILBARCO NN1 208525-1 93 1 0 Approved 5.000 GILBARCO NN1 208525-2 87 2 0 Approved 5.000 GILBARCO NN1 208525-2 89 2 0 Approved 5.000 GILBARCO NN1 208525-2 93 2 0 Approved 5.000 GILBARCO NN1 208523-3 87 3 0 Approved 5.000 GILBARCO NN1 208523-3 89 3 0 Approved 5.000 GILBARCO NN1 208523-3 93 3 0 Approved 5.000 GILBARCO NN1 208523-4 87 4 0 Approved 5.000 GILBARCO NN1 208523-4 89 4 0 Approved 5.000 GILBARCO NN1 208523-4 93 4 0 Approved 5.000 GILBARCO NN1 208524-5 87 5 0 Approved 5.000 GILBARCO NN1 208524-5 89 5 0 Approved 5.000 GILBARCO NN1 208524-5 93 5 0 Approved 5.000 GILBARCO NN1 208524-6 87 6 0 Approved 5.000 GILBARCO NN1 208524-6 89 6 0 Approved 5.000 GILBARCO NN1 208524-6 93 6 0 Approved 5.000 GILBARCO NN1 208521-9 87 9 0 Approved 5.000 GILBARCO NN1 208521-9 89 9 0 Approved 5.000
Page 198 of 466
Inspector Acknowledged Receipt: MINA LPATEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 208521-9 93 9 0 Approved 5.000 GILBARCO NN1 208521-10 87 10 0 Approved 5.000 GILBARCO NN1 208521-10 89 10 0 Approved 5.000 GILBARCO NN1 208521-10 93 10 0 Approved 5.000 GILBARCO NN1 208522--11 87 11 0 Approved 5.000 GILBARCO NN1 208522--11 89 11 0 Approved 5.000 GILBARCO NN1 208522--11 93 11 0 Approved 5.000 GILBARCO NN1 208522-12 87 12 0 Approved 5.000 GILBARCO NN1 208522-12 89 12 0 Approved 5.000 GILBARCO NN1 208522-12 93 12 0 Approved 5.000 GILBARCO NL1 208626-7 87 7 0 Approved 5.000 GILBARCO NL1 208626-7 89 7 0 Approved 5.000 GILBARCO NL1 208626-7 93 7 0 Approved 5.000 GILBARCO NL1 208626-7 Diesel 7 0 Approved 5.000 GILBARCO NL1 208626-8 87 8 0 Approved 5.000 GILBARCO NL1 208626-8 89 8 0 Approved 5.000 GILBARCO NL1 208626-8 93 8 0 Approved 5.000 GILBARCO NL1 208626-8 Diesel 8 0 Approved 5.000 GILBARCO NP3 207346-13 Diesel 13 0 Approved 5.000 GILBARCO NP3 207346-14 Diesel 14 0 Approved 5.000GILBARCO JH1000 098811-15 Kerosene 15 0 Approved 5.000
Device Product Used: 205. Insp Product Used: . Tot Product Used: 205.Grade Prod Used87 60.0089 60.0093 60.00Diesel 20.00Kerosene 5.00
Billing Address:
,
Page 199 of 466
Inspector Acknowledged Receipt: MINA LPATEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Notes:
Page 200 of 466
Inspector Acknowledged Receipt: MINA LPATEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/21/2011 Business ID: 00163439 Inspection: AU001249Business: LUCKY MART Store #:
200 E WILLIAMSBURG RD Phone: (804)737-7717Inspector: 325 MIKE TILLMAN
SANDSTON, VA 23150 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 29 29Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE V590D1/GQUY 683962-3 87 3 0 Approved 5.000WAYNE V590D1/GQUY 683964-1 87 1 0 Approved 5.000WAYNE V590D1/GQUY 683964-1 89 1 0 Approved 5.000WAYNE V590D1/GQUY 683964-1 93 1 0 Approved 5.000WAYNE V590D1/GQUY 683964-2 87 2 0 Approved 5.000WAYNE V590D1/GQUY 683964-2 89 2 0 Approved 5.000WAYNE V590D1/GQUY 683964-2 93 2 0 Approved 5.000WAYNE V590D1/GQUY 683962-3 89 3 0 Approved 5.000WAYNE V590D1/GQUY 683962-3 93 3 0 Approved 5.000WAYNE V590D1/GQUY 683962-4 87 4 0 Approved 5.000WAYNE V590D1/GQUY 683962-4 89 4 0 Approved 5.000WAYNE V590D1/GQUY 683962-4 93 4 0 Approved 5.000WAYNE V590D1/GQUY 683963-7 87 7 0 Approved 5.000WAYNE V590D1/GQUY 683963-7 89 7 0 Approved 5.000WAYNE V590D1/GQUY 683963-7 93 7 0 Approved 5.000WAYNE V590D1/GQUY 683963-8 87 8 0 Approved 5.000WAYNE V590D1/GQUY 683963-8 89 8 0 Approved 5.000WAYNE V590D1/GQUY 683963-8 93 8 0 Approved 5.000WAYNE 3/595D4/60/5D 25063A-5 87 5 0 Approved 5.000WAYNE 3/595D4/60/5D 25063A-5 89 5 0 Approved 5.000
Page 201 of 466
Inspector Acknowledged Receipt: LAKHMIR BAGGA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 3/595D4/60/5D 25063A-5 92 5 0 Approved 5.000WAYNE 3/595D4/60/5D 25063A-5 93 5 0 Approved 5.000WAYNE 3/595D4/60/5D 25063A-5 Diesel 5 0 Approved 5.000WAYNE 3/595D4/60/5D 25063A-6 87 6 0 Approved 5.000WAYNE 3/595D4/60/5D 25063A-6 89 6 0 Approved 5.000WAYNE 3/595D4/60/5D 25063A-6 92 6 0 Approved 5.000WAYNE 3/595D4/60/5D 25063A-6 93 6 0 Approved 5.000WAYNE 3/595D4/60/5D 25063A-6 Diesel 6 0 Approved 5.000WAYNE DL3 3671L19 5877787-9 Kerosene 9 0 Approved 0.000
Device Product Used: 140. Insp Product Used: . Tot Product Used: 140.Grade Prod Used87 40.0089 40.0092 10.0093 40.00Diesel 10.00
Billing Address:
,
Notes:
Page 202 of 466
Inspector Acknowledged Receipt: LAKHMIR BAGGA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/22/2011 Business ID: 00161691 Inspection: AU001257Business: UPPY S EXXON Store #: #36
8208 W BROAD ST Phone: 804-965-9082Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 2 2
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B05 PA048024-8 87 8 0 Approved 5.000GILBARCO B05 PA072629-1 93 1 0 Approved 5.000
Device Product Used: 10. Insp Product Used: . Tot Product Used: 10.Grade Prod Used87 5.0093 5.00
Billing Address:
,
Notes:
Page 203 of 466
Inspector Acknowledged Receipt: KATHY MADDY
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/22/2011 Business ID: 00110560 Inspection: AU001258Business: PARHAM BP Store #:
9100 THREE CHOPT RD Phone: 804-270-4798Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 2 2
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H426B- PMR036426-9 87 9 0 Rejected 0.000TOKHEIM H426B- PMR036426-10 93 10 0 Rejected 0.000
Billing Address:
,
Notes:
NO REPAIRS DONE
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
Page 204 of 466
Inspector Acknowledged Receipt: MANISH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 205 of 466
Inspector Acknowledged Receipt: MANISH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/23/2011 Business ID: 00248860 Inspection: AU001259Business: WAWA Store #: #8603
8017 W BROAD STREET Phone: (804)290-4374Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23294 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 52 37 9 6Gas Station 1 1Small Capacity Scale 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NL1 EWEN198440-1 87 1 0 Approved 5.000 GILBARCO NL1 EWEN198440-1 89 1 0 Approved 5.000 GILBARCO NL1 EWEN198440-1 93 1 0 Approved 5.000 GILBARCO NL1 EWEN198440-1 Diesel 1 0 Approved 5.000 GILBARCO NL1 EWEN198440-2 87 2 0 Approved 5.000 GILBARCO NL1 EWEN198440-2 89 2 0 Approved 5.000 GILBARCO NL1 EWEN198440-2 93 2 0 Approved 5.000 GILBARCO NL1 EWEN198440-2 Diesel 2 0 Approved 5.000 GILBARCO NL1 EWEN198439-9 87 9 0 Approved 5.000 GILBARCO NL1 EWEN198439-9 89 9 0 Approved 5.000 GILBARCO NL1 EWEN198439-9 93 9 0 Approved 5.000 GILBARCO NL1 EWEN198439-9 Diesel 9 0 Approved 5.000 GILBARCO NL1 EWEN198439-10 87 10 0 Approved 5.000 GILBARCO NL1 EWEN198439-10 89 10 0 Approved 5.000 GILBARCO NL1 EWEN198439-10 93 10 0 Approved 5.000 GILBARCO NL1 EWEN198439-10 Diesel 10 0 Approved 5.000GILBARCO NN1 MPEN085121-15 87 15 0 Approved 5.000GILBARCO NN1 MPEN085121-15 89 15 0 Approved 5.000GILBARCO NN1 MPEN085121-15 93 15 0 Approved 5.000
Page 206 of 466
Inspector Acknowledged Receipt: SHANE MASON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 MPEN085115-3 87 3 9 Rejected 5.000GILBARCO NN1 MPEN085115-3 89 3 20 Rejected 5.000GILBARCO NN1 MPEN085115-3 93 3 0 Rejected 5.000GILBARCO NN1 MPEN085115-4 87 4 0 Rejected 5.000GILBARCO NN1 MPEN085115-4 89 4 0 Rejected 5.000GILBARCO NN1 MPEN085115-4 93 4 0 Rejected 5.000GILBARCO NN1 MPEN085120-5 87 5 0 Rejected 5.000GILBARCO NN1 MPEN085120-5 89 5 0 Rejected 5.000GILBARCO NN1 MPEN085120-5 93 5 0 Rejected 5.000GILBARCO NN1 MPEN085120-6 87 6 0 Approved 5.000GILBARCO NN1 MPEN085120-6 89 6 0 Approved 5.000GILBARCO NN1 MPEN085120-6 93 6 0 Approved 5.000GILBARCO NN1 JPEN079066-7 87 7 0 Not Tested 0.000GILBARCO NN1 JPEN079066-7 89 7 0 Not Tested 0.000GILBARCO NN1 JPEN079066-7 93 7 0 Not Tested 0.000GILBARCO NN1 JPEN079066-8 87 8 0 Not Tested 0.000GILBARCO NN1 JPEN079066-8 89 8 0 Not Tested 0.000GILBARCO NN1 JPEN079066-8 93 8 0 Not Tested 0.000GILBARCO NN1 MPEN085119-11 87 11 0 Approved 5.000GILBARCO NN1 MPEN085119-11 89 11 0 Approved 5.000GILBARCO NN1 MPEN085119-11 93 11 0 Approved 5.000GILBARCO NN1 MPEN085119-12 87 12 0 Approved 5.000GILBARCO NN1 MPEN085119-12 89 12 0 Approved 5.000GILBARCO NN1 MPEN085119-12 93 12 0 Approved 5.000GILBARCO NN1 MPEN085117-13 87 13 0 Approved 5.000GILBARCO NN1 MPEN085117-13 89 13 0 Approved 5.000GILBARCO NN1 MPEN085117-13 93 13 0 Approved 5.000GILBARCO NN1 MPEN085117-14 87 14 0 Approved 5.000GILBARCO NN1 MPEN085117-14 89 14 0 Approved 5.000GILBARCO NN1 MPEN085117-14 93 14 0 Approved 5.000GILBARCO NN1 MPEN085121-16 87 16 0 Approved 5.000GILBARCO NN1 MPEN085121-16 89 16 0 Approved 5.000GILBARCO NN1 MPEN085121-16 93 16 0 Approved 5.000
Device Product Used: 230. Insp Product Used: . Tot Product Used: 230.Grade Prod Used
Page 207 of 466
Inspector Acknowledged Receipt: SHANE MASON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
87 70.0089 70.0093 70.00Diesel 20.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
Page 208 of 466
Inspector Acknowledged Receipt: SHANE MASON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 209 of 466
Inspector Acknowledged Receipt: SHANE MASON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/24/2011 Business ID: 00021050 Inspection: AU001263Business: VARINA MARKET Store #:
4110 DARBYTOWN RD Phone: 804-795-7892Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 10 10
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B85 PA202186-1 89 1 0 Approved 0.000GILBARCO B85 PA202186-2 Diesel 2 0 Approved 0.000GILBARCO B79 PA174519-4 89 4 0 Approved 0.000GILBARCO B79 PA174519-4 93 4 0 Approved 0.000GILBARCO B79 PA174520-5 87 5 0 Approved 0.000GILBARCO B79 PA174520-5 89 5 0 Approved 0.000GILBARCO B79 PA174520-5 93 5 0 Approved 0.000GILBARCO B79 PA174520-6 87 6 0 Approved 0.000GILBARCO B79 PA174520-6 89 6 0 Approved 0.000GILBARCO B79 PA174520-6 93 6 0 Approved 0.000
Billing Address:
,
Notes:
Page 210 of 466
Inspector Acknowledged Receipt: JAYUL GANDHI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/28/2011 Business ID: 00163583 Inspection: AU001265Business: NORTH PARK SHELL Store #: #10
805 PARHAM RD Phone: 804-266-4407Inspector: 325 MIKE TILLMAN
RICHM0ND, VA 23227 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 40 40Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B78 PA141845-1 87 1 0 Approved 5.000GILBARCO B78 PA141847-5 87 5 0 Approved 5.000GILBARCO B78 PA141848-12 87 12 0 Approved 5.000GILBARCO B78 PA141845-1 89 1 0 Approved 5.000GILBARCO B78 PA141845-1 93 1 0 Approved 5.000GILBARCO B78 PA141845-2 87 2 0 Approved 5.000GILBARCO B78 PA141845-2 89 2 0 Approved 5.000GILBARCO B78 PA141845-2 93 2 0 Approved 5.000GILBARCO B78 PA141847-5 89 5 0 Approved 5.000GILBARCO B78 PA141847-5 93 5 0 Approved 5.000GILBARCO B78 PA141847-6 87 6 0 Approved 5.000GILBARCO B78 PA141847-6 89 6 0 Approved 5.000GILBARCO B78 PA141847-6 93 6 0 Approved 5.000GILBARCO B78 PA131846-7 87 7 0 Approved 5.000GILBARCO B78 PA131846-7 89 7 0 Approved 5.000GILBARCO B78 PA131846-7 93 7 0 Approved 5.000GILBARCO B78 PA141846-8 87 8 0 Approved 5.000GILBARCO B78 PA141846-8 89 8 0 Approved 5.000GILBARCO B78 PA141846-8 93 8 0 Approved 5.000GILBARCO B78 PA141848-11 87 11 0 Approved 5.000
Page 211 of 466
Inspector Acknowledged Receipt: KUMAR BURRE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B78 PA141848-11 89 11 0 Approved 5.000GILBARCO B78 PA141848-11 93 11 0 Approved 5.000GILBARCO B78 PA141848-12 89 12 0 Approved 5.000GILBARCO B78 PA141848-12 93 12 0 Approved 5.000GILBARCO B7C PA141850-3 87 3 0 Approved 5.000GILBARCO B7C PA141850-3 89 3 0 Approved 5.000GILBARCO B7C PA141850-3 93 3 0 Approved 5.000GILBARCO B7C PA141850-3 Diesel 3 0 Approved 5.000GILBARCO B7C PA141850-4 87 4 0 Approved 5.000GILBARCO B7C PA141850-4 89 4 0 Approved 5.000GILBARCO B7C PA141850-4 93 4 0 Approved 5.000GILBARCO B7C PA141850-4 Diesel 4 0 Approved 5.000GILBARCO B7C PA141849-9 87 9 0 Approved 5.000GILBARCO B7C PA141849-9 89 9 0 Approved 5.000GILBARCO B7C PA141849-9 93 9 0 Approved 5.000GILBARCO B7C PA141849-9 Diesel 9 0 Approved 5.000GILBARCO B7C PA141849-10 87 10 0 Approved 5.000GILBARCO B7C PA141849-10 89 10 0 Approved 5.000GILBARCO B7C PA141849-10 93 10 0 Approved 5.000GILBARCO B7C PA141849-10 Diesel 10 0 Approved 5.000
Device Product Used: 200. Insp Product Used: . Tot Product Used: 200.Grade Prod Used87 60.0089 60.0093 60.00Diesel 20.00
Billing Address:
,
Notes:
Page 212 of 466
Inspector Acknowledged Receipt: KUMAR BURRE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/28/2011 Business ID: 00113657 Inspection: AU001266Business: MEGA MART Store #:
1611 MOUNTAIN RD Phone: (804)553-1458Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 27 20 7Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B65 PA051310-1 87 1 0 Approved 5.000GILBARCO B65 PA051310-1 89 1 0 Approved 5.000GILBARCO B65 PA051310-1 93 1 0 Approved 5.000GILBARCO B65 PA051310-2 87 2 0 Approved 5.000GILBARCO B65 PA051310-2 89 2 0 Approved 5.000GILBARCO B65 PA051310-2 93 2 0 Approved 5.000GILBARCO B65 PA051590-3 87 3 0 Approved 5.000GILBARCO B65 PA051590-3 89 3 0 Approved 5.000GILBARCO B65 PA051590-3 93 3 0 Approved 5.000GILBARCO B65 PA051590-4 87 4 0 Approved 5.000GILBARCO B65 PA051590-4 89 4 0 Approved 5.000GILBARCO B65 PA051590-4 93 4 0 Approved 5.000GILBARCO B65 PA051312-5 87 5 0 Approved 5.000GILBARCO B65 PA051312-5 89 5 0 Approved 5.000GILBARCO B65 PA051312-5 93 5 0 Approved 5.000GILBARCO B65 PA051312-6 87 6 0 Approved 5.000GILBARCO B65 PA051312-6 89 6 0 Approved 5.000GILBARCO B65 PA051312-6 93 6 0 Approved 5.000GILBARCO AC1921191 02622-9 Diesel 9 0 Approved 5.000GILBARCO AC1921191 02622-10 Diesel 10 0 Approved 5.000
Page 213 of 466
Inspector Acknowledged Receipt: K. ALAM
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO RAC 1921 A 2412-11 Kerosene 11 0 Rejected 5.000GILBARCO B65 PA051313-7 87 7 0 Rejected 0.000GILBARCO B65 PA051313-7 89 7 0 Rejected 0.000GILBARCO B65 PA051313-7 93 7 0 Rejected 0.000GILBARCO B65 PA051313-8 87 8 0 Rejected 0.000GILBARCO B65 PA051313-8 89 8 0 Rejected 0.000GILBARCO B65 PA051313-8 93 8 0 Rejected 0.000
Device Product Used: 105. Insp Product Used: . Tot Product Used: 105.Grade Prod Used87 30.0089 30.0093 30.00Diesel 10.00Kerosene 5.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANS
Page 214 of 466
Inspector Acknowledged Receipt: K. ALAM
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Service Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 215 of 466
Inspector Acknowledged Receipt: K. ALAM
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/29/2011 Business ID: 00111217 Inspection: AU001267Business: PATTERSON GAS MART Store #: #39
10446 PATTERSON AVE Phone: 804-740-2119Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23239 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 26 25 1Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H422C 0601126105164-1 87 1 0 Approved 5.000TOKHEIM H422C 0601126105164-1 89 1 0 Approved 5.000TOKHEIM H422C 0601126105164-1 93 1 0 Approved 5.000TOKHEIM H422C 0900126005553-2 87 2 0 Approved 5.000TOKHEIM H422C 0900126005553-2 89 2 0 Approved 5.000TOKHEIM H422C 0900126005553-2 93 2 0 Approved 5.000TOKHEIM H422C 0900126005553-3 87 3 0 Approved 5.000TOKHEIM H422C 0900126005553-3 89 3 0 Approved 5.000TOKHEIM H422C 0900126005553-3 93 3 0 Approved 5.000TOKHEIM H422C 0900126005570-4 87 4 0 Approved 5.000TOKHEIM H422C 0900126005570-4 89 4 0 Approved 5.000TOKHEIM H422C 0900126005570-4 93 4 0 Approved 5.000TOKHEIM H422C 0900126005570-5 87 5 0 Approved 5.000TOKHEIM H422C 0900126005570-5 89 5 0 Approved 5.000TOKHEIM H422C 0900126005570-5 93 5 0 Approved 5.000TOKHEIM H424C 0800126005573-6 87 6 0 Approved 5.000TOKHEIM H424C 0800126005573-6 89 6 0 Approved 5.000TOKHEIM H424C 0800126005573-6 93 6 0 Approved 5.000TOKHEIM H424C 0800126005573-6 Diesel 6 0 Approved 5.000TOKHEIM H424C 0800126005573-7 87 7 0 Approved 5.000
Page 216 of 466
Inspector Acknowledged Receipt: RAMESH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H424C 0800126005573-7 89 7 0 Approved 5.000TOKHEIM H424C 0800126005573-7 93 7 0 Approved 5.000TOKHEIM H424C 0800126005573-7 Diesel 7 0 Approved 5.000TOKHEIM 262R 049262019587-8 Diesel 8 0 Approved 5.000TOKHEIM 2621RCTW 03926219223-9 Kerosene 9 0 Not Tested 0.000TOKHEIM 2621RCTW 03926219223-10 Kerosene 10 0 Approved 5.000
Device Product Used: 125. Insp Product Used: . Tot Product Used: 125.Grade Prod Used87 35.0089 35.0093 35.00Diesel 15.00Kerosene 5.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled
Page 217 of 466
Inspector Acknowledged Receipt: RAMESH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
"Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 218 of 466
Inspector Acknowledged Receipt: RAMESH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/29/2011 Business ID: 00021432 Inspection: AU001268Business: PUMP MART CONVENIENCE EXXON Store #:
10504 PATTERSON AVE Phone: (804)741-7562Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 24 24Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H426B- PMP06843-1 87 1 0 Approved 5.000TOKHEIM H426B- PMP06843-3 87 3 0 Approved 5.000TOKHEIM H426B- PMP06843-1 89 1 0 Approved 5.000TOKHEIM H426B- PMP06843-1 93 1 0 Approved 5.000TOKHEIM H426B- PMP06843-3 89 3 0 Approved 5.000TOKHEIM H426B- PMP06843-3 93 3 0 Approved 5.000TOKHEIM H426B- PMP06840-2 87 2 0 Approved 5.000TOKHEIM H426B- PMP06840-2 89 2 0 Approved 5.000TOKHEIM H426B- PMP06840-2 93 2 0 Approved 5.000TOKHEIM H426B- PMP06840-4 87 4 0 Approved 5.000TOKHEIM H426B- PMP06840-4 89 4 0 Approved 5.000TOKHEIM H426B- PMP06840-4 93 4 0 Approved 5.000TOKHEIM H426B- PMP06825-5 87 5 0 Approved 5.000TOKHEIM H426B- PMP06825-5 89 5 0 Approved 5.000TOKHEIM H426B- PMP06825-5 93 5 0 Approved 5.000TOKHEIM H426B- PMP06825-7 87 7 0 Approved 5.000TOKHEIM H426B- PMP06825-7 89 7 0 Approved 5.000TOKHEIM H426B- PMP06825-7 93 7 0 Approved 5.000TOKHEIM H426B- PMP06824-6 87 6 0 Approved 5.000TOKHEIM H426B- PMP06824-6 89 6 0 Approved 5.000
Page 219 of 466
Inspector Acknowledged Receipt: PATEL JITENDL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H426B- PMP06824-6 93 6 0 Approved 5.000TOKHEIM H426B- PMP06824-8 87 8 0 Approved 5.000TOKHEIM H426B- PMP06824-8 89 8 0 Approved 5.000TOKHEIM H426B- PMP06824-8 93 8 0 Approved 5.000
Device Product Used: 120. Insp Product Used: . Tot Product Used: 120.Grade Prod Used87 40.0089 40.0093 40.00
Billing Address:
,
Notes:
Page 220 of 466
Inspector Acknowledged Receipt: PATEL JITENDL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/29/2011 Business ID: 00111983 Inspection: AU001269Business: TUCKAHOE BP Store #:
11310 PATTERSON AVE Phone: (804)740-5748Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 24 24Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 DTEN 146611-1 87 1 0 Approved 5.000GILBARCO NN1 DTEN 146611-1 89 1 0 Approved 5.000GILBARCO NN1 DTEN 146611-1 93 1 0 Approved 5.000GILBARCO NN1 DTEN146611-2 87 2 0 Approved 5.000GILBARCO NN1 DTEN146611-2 89 2 0 Approved 5.000 GILBARCO NN1 DTEN146611-2 93 2 0 Approved 5.000GILBARCO NN1 DTEN146609-3 87 3 0 Approved 5.000GILBARCO NN1 DTEN146609-3 89 3 0 Approved 5.000GILBARCO NN1 DTEN146609-3 93 3 0 Approved 5.000GILBARCO NN1 DTEN146609-4 87 4 0 Approved 5.000GILBARCO NN1 DTEN146609-4 89 4 0 Approved 5.000GILBARCO NN1 DTEN146609-4 93 4 0 Approved 5.000GILBARCO NN1 DTEN146610-5 87 5 0 Approved 5.000GILBARCO NN1 DTEN146610-5 89 5 0 Approved 5.000GILBARCO NN1 DTEN146610-5 93 5 0 Approved 5.000GILBARCO NN1 DTEN146610-6 87 6 0 Approved 5.000GILBARCO NN1 DTEN146610-6 89 6 b 0 Approved 5.000GILBARCO NN1 DTEN146610-6 93 6 0 Approved 5.000GILBARCO NN1 DTEN146608-7 87 7 0 Approved 5.000GILBARCO NN1 DTEN146608-7 89 7 0 Approved 5.000
Page 221 of 466
Inspector Acknowledged Receipt: STACY MCCAULEY
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 DTEN146608-7 93 7 0 Approved 5.000GILBARCO NN1 DTEN146608-8 87 8 0 Approved 5.000GILBARCO NN1 DTEN146608-8 89 8 0 Approved 5.000GILBARCO NN1 DTEN146608-8 93 8 0 Approved 5.000
Device Product Used: 120. Insp Product Used: . Tot Product Used: 120.Grade Prod Used87 40.0089 40.0093 40.00
Billing Address:
,
Notes:
Page 222 of 466
Inspector Acknowledged Receipt: STACY MCCAULEY
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/29/2011 Business ID: 00111990 Inspection: AU001270Business: SEIBERTS PUMP & CHURCH BP Store #: #111
11902 CHURCH RD Phone: (804)360-3151Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 24 24Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NGO 177119-1 87 1 0 Approved 5.000GILBARCO NGO 177119-1 89 1 0 Approved 5.000GILBARCO NGO 177119-1 93 1 0 Approved 5.000GILBARCO NGO 177119-2 87 2 0 Approved 5.000GILBARCO NGO 177119-2 89 2 0 Approved 5.000GILBARCO NGO 177119-2 93 2 0 Approved 5.000GILBARCO NGO 177118-3 87 3 0 Approved 5.000GILBARCO NGO 177118-3 89 3 0 Approved 5.000GILBARCO NGO 177118-3 93 3 0 Approved 5.000GILBARCO NGO 177118-4 87 4 0 Approved 5.000GILBARCO NGO 177118-4 89 4 0 Approved 5.000GILBARCO NGO 177118-4 93 4 0 Approved 5.000GILBARCO NGO 177117-5 87 5 0 Approved 5.000GILBARCO NGO 177117-5 89 5 0 Approved 5.000GILBARCO NGO 177117-5 93 5 0 Approved 5.000GILBARCO NGO 177117-6 87 6 bb 0 Approved 5.000GILBARCO NGO 177117-6 89 6 0 Approved 5.000GILBARCO NGO 177117-6 93 6 0 Approved 5.000GILBARCO NGO 177120-7 87 7 0 Approved 5.000GILBARCO NGO 177120-7 89 7 0 Approved 5.000
Page 223 of 466
Inspector Acknowledged Receipt: MARY K ATKINSON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NGO 177120-7 93 7 0 Approved 5.000GILBARCO NGO 177120-8 87 8 0 Approved 5.000GILBARCO NGO 177120-8 89 8 0 Approved 5.000GILBARCO NGO 177120-8 93 8 0 Approved 5.000
Device Product Used: 120. Insp Product Used: . Tot Product Used: 120.Grade Prod Used87 40.0089 40.0093 40.00
Billing Address:
,
Notes:
Page 224 of 466
Inspector Acknowledged Receipt: MARY K ATKINSON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/30/2011 Business ID: 00110848 Inspection: AU001271Business: HESS Store #: 46504
3801 MECHANICSVILLE TNPK Phone: 804-329-3921Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 40 25 12 3Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE V387D1/GQY 648496-13 Diesel 13 0 Approved 5.000WAYNE V390D1/GQY 649709-1 87 1 0 Approved 5.000WAYNE V390D1/GQY 649709-1 89 1 0 Approved 5.000WAYNE V390D1/GQY 649709-1 93 1 0 Approved 5.000WAYNE V390D1/GQY 649709-2 87 2 0 Approved 5.000WAYNE V390D1/GQY 649709-2 89 2 0 Approved 5.000WAYNE V390D1/GQY 649709-2 93 2 0 Approved 5.000WAYNE V390D1/GQY 649708-3 87 3 0 Condemned 5.000WAYNE V390D1/GQY 649708-3 89 3 0 Approved 5.000WAYNE V390D1/GQY 649708-3 93 3 0 Approved 5.000WAYNE V390D1/GQY 649708-4 87 4 0 Rejected 5.000WAYNE V390D1/GQY 649708-4 89 4 0 Condemned 5.000WAYNE V390D1/GQY 649708-4 93 4 0 Rejected 5.000WAYNE V390D1/GQY 714414-5 87 5 0 Condemned 5.000WAYNE V390D1/GQY 714414-5 89 5 0 Approved 5.000WAYNE V390D1/GQY 714414-5 93 5 0 Approved 5.000WAYNE V390D1/GQY 714414-6 87 6 0 Approved 5.000WAYNE V390D1/GQY 714414-6 89 6 0 Approved 5.000WAYNE V390D1/GQY 714414-6 93 6 0 Approved 5.000WAYNE V390D1/GQY 649710-7 87 7 0 Approved 5.000
Page 225 of 466
Inspector Acknowledged Receipt: NURUL kHALIFA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE V390D1/GQY 649710-7 89 7 0 Approved 5.000WAYNE V390D1/GQY 649710-7 93 7 0 Approved 5.000WAYNE V390D1/GQY 649710-8 87 8 0 Rejected 5.000WAYNE V390D1/GQY 649710-8 89 8 0 Approved 5.000WAYNE V390D1/GQY 649710-8 93 8 0 Approved 5.000WAYNE V390D1/GQY 649707-9 87 9 0 Approved 5.000WAYNE V390D1/GQY 649707-9 89 9 0 Approved 5.000WAYNE V390D1/GQY 649707-9 93 9 0 Approved 5.000WAYNE V390D1/GQY 649707-10 87 10 0 Rejected 5.000WAYNE V390D1/GQY 649707-10 89 10 0 Rejected 5.000WAYNE V390D1/GQY 649707-10 93 10 0 Rejected 5.000WAYNE V390D1/GQY 714415-11 87 11 0 Rejected 5.000WAYNE V390D1/GQY 714415-11 89 11 0 Rejected 5.000WAYNE V390D1/GQY 714415-11 93 11 0 Rejected 5.000WAYNE V390D1/GQY 714415-12 87 12 0 Approved 5.000WAYNE V390D1/GQY 714415-12 89 12 0 Approved 5.000WAYNE V390D1/GQY 714415-12 93 12 0 Approved 5.000WAYNE V387D1/GQY 648496-14 Diesel 14 0 Rejected 5.000WAYNE V387D1/GQY 648499-15 Kerosene 15 0 Rejected 5.000WAYNE V387D1/GQY 648499-16 Kerosene 16 0 Rejected 5.000
Device Product Used: 200. Insp Product Used: . Tot Product Used: 200.Grade Prod Used87 60.0089 60.0093 60.00Diesel 10.00Kerosene 10.00
Billing Address:
,
Notes:
Page 226 of 466
Inspector Acknowledged Receipt: NURUL kHALIFA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Page 227 of 466
Inspector Acknowledged Receipt: NURUL kHALIFA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 228 of 466
Inspector Acknowledged Receipt: NURUL kHALIFA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 6/30/2011 Business ID: 00021311 Inspection: AU001272Business: TURNPIKE MARKET Store #:
2601 MECHANICSVILLE TNPK Phone: (804)788-0029Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 25 24 1Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO Bb LUEN177100-1 87 1 0 Approved 5.000 GILBARCO Bb LUEN177100-1 89 1 0 Approved 5.000 GILBARCO Bb LUEN177100-1 93 1 0 Approved 5.000 GILBARCO Bb LUEN177100-2 87 2 0 Approved 5.000 GILBARCO Bb LUEN177100-2 89 2 0 Approved 5.000 GILBARCO Bb LUEN177100-2 93 2 0 Approved 5.000 GILBARCO Bb LUEN177101-3 87 3 0 Approved 5.000 GILBARCO Bb LUEN177101-3 89 3 0 Approved 5.000 GILBARCO Bb LUEN177101-3 93 3 0 Approved 5.000 GILBARCO Bb LUEN177101-4 87 4 0 Approved 5.000 GILBARCO Bb LUEN177101-4 89 4 0 Approved 5.000 GILBARCO Bb LUEN177101-4 93 4 0 Approved 5.000 GILBARCO Bb LUEN177102-5 87 5 0 Approved 5.000 GILBARCO Bb LUEN177102-5 89 5 0 Approved 5.000 GILBARCO Bb LUEN177102-5 93 5 0 Approved 5.000 GILBARCO Bb LUEN177102-6 87 6 0 Approved 5.000 GILBARCO Bb LUEN177102-6 89 6 0 Approved 5.000 GILBARCO Bb LUEN177102-6 93 6 0 Approved 5.000 GILBARCO Bb LUEN177099-7 87 7 0 Approved 5.000 GILBARCO Bb LUEN177099-7 89 7 0 Approved 5.000
Page 229 of 466
Inspector Acknowledged Receipt: NICK PATEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO Bb LUEN177099-7 93 7 0 Approved 5.000 GILBARCO Bb LUEN177099-8 87 8 0 Approved 5.000 GILBARCO Bb LUEN177099-8 89 8 0 Approved 5.000 GILBARCO Bb LUEN177099-8 93 8 0 Approved 5.000 GILBARCO JH1000 KUA095789 Kerosene 9 0 Not Tested 0.000
Device Product Used: 120. Insp Product Used: . Tot Product Used: 120.Grade Prod Used87 40.0089 40.0093 40.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service
Page 230 of 466
Inspector Acknowledged Receipt: NICK PATEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 231 of 466
Inspector Acknowledged Receipt: NICK PATEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/5/2011 Business ID: 00500740 Inspection: AU001273Business: 7 - EIEVEN #34015 Store #: #34015
9500 W. BROAD ST Phone: 804-270-4345Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23294 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 30 30Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 KTEN156042-6 93 6 0 Approved 5.000GILBARCO NN1 KTEN156044-1 87 1 0 Approved 5.000GILBARCO NN1 KTEN156044-1 93 1 0 Approved 5.000GILBARCO NN1 KTEN156042-5 89 5 0 Approved 5.000GILBARCO NN1 KTEN156042-5 93 5 0 Approved 5.000GILBARCO NN1 KTEN156044-1 89 1 0 Approved 5.000GILBARCO NN1 KTEN156042-6 89 6 0 Approved 5.000GILBARCO NN1 KTEN156044-2 87 2 0 Approved 5.000GILBARCO NN1 KTEN156044-2 89 2 0 Approved 5.000GILBARCO NN1 KTEN156044-2 93 2 0 Approved 5.000GILBARCO NN1 KTEN156045-3 87 3 0 Approved 5.000GILBARCO NN1 KTEN156045-3 89 3 0 Approved 5.000GILBARCO NN1 KTEN156045-3 93 3 0 Approved 5.000GILBARCO NN1 KTEN156045-4 87 4 0 Approved 5.000GILBARCO NN1 KTEN156045-4 89 4 0 Approved 5.000GILBARCO NN1 KTEN156045-4 93 4 0 Approved 5.000GILBARCO NN1 KTEN156042-5 87 5 0 Approved 5.000GILBARCO NN1 KTEN156042-6 87 6 0 Approved 5.000GILBARCO NN1 KTEN156043-7 87 7 0 Approved 5.000GILBARCO NN1 KTEN156043-7 89 7 0 Approved 5.000
Page 232 of 466
Inspector Acknowledged Receipt: AKMAL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 KTEN156043-7 93 7 0 Approved 5.000GILBARCO NN1 KTEN156043-8 87 8 0 Approved 5.000GILBARCO NN1 KTEN156043-8 89 8 0 Approved 5.000GILBARCO NN1 KTEN156043-8 93 8 0 Approved 5.000GILBARCO NN1 KTEN156041-9 87 9 0 Approved 5.000GILBARCO NN1 KTEN156041-9 89 9 0 Approved 5.000GILBARCO NN1 KTEN156041-9 93 9 0 Approved 5.000GILBARCO NN1 KTEN156041-10 87 10 0 Approved 5.000GILBARCO NN1 KTEN156041-10 89 10 0 Approved 5.000GILBARCO NN1 KTEN156041-10 93 10 0 Approved 5.000
Device Product Used: 150. Insp Product Used: . Tot Product Used: 150.Grade Prod Used87 50.0089 50.0093 50.00
Billing Address:
,
Notes:
Page 233 of 466
Inspector Acknowledged Receipt: AKMAL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/5/2011 Business ID: 00163076 Inspection: AU001274Business: EXXON WEST END Store #: #28407
9525 W BROAD ST Phone: (804)615-5102Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 24 17 5 2Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO AK1220 700076-1 87 1 0 Approved 5.000GILBARCO AK1220 700076-2 87 2 0 Approved 5.000GILBARCO AK1220 700076-1 89 1 0 Approved 5.000GILBARCO AK1220 700076-2 89 2 0 Approved 5.000GILBARCO AK1220 700076-1 93 1 0 Approved 5.000GILBARCO AK1220 700076-2 93 2 0 Approved 5.000GILBARCO AK1220 CA014202-5 87 5 0 Approved 5.000GILBARCO AK1220 CA014202-5 89 5 0 Approved 5.000GILBARCO AK1220 CA014202-5 93 5 0 Approved 5.000GILBARCO AK1220 CA013960-3 87 3 0 Rejected 5.000GILBARCO AK1220 CA013960-3 89 3 0 Rejected 5.000GILBARCO AK1220 CA013960-3 93 3 0 Rejected 5.000GILBARCO AK1220 CA013960-4 87 4 0 Approved 5.000GILBARCO AK1220 CA013960-4 89 4 0 Approved 5.000GILBARCO AK1220 CA013960-4 93 4 0 Condemned 5.000GILBARCO AK1220 CA014202-6 87 6 0 Approved 5.000GILBARCO AK1220 CA014202-6 89 6 0 Approved 5.000GILBARCO AK1220 CA014202-6 93 6 0 Approved 5.000GILBARCO AK1220 CA014204-7 87 7 0 Approved 5.000GILBARCO AK1220 CA014204-7 89 7 0 Approved 5.000
Page 234 of 466
Inspector Acknowledged Receipt: SHER SINGH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO AK1220 CA014204-7 93 7 0 Approved 5.000GILBARCO AK1220 CA014204-8 87 8 0 Rejected 5.000GILBARCO AK1220 CA014204-8 89 8 0 Rejected 5.000GILBARCO AK1220 CA014204-8 93 8 0 Condemned 5.000
Device Product Used: 120. Insp Product Used: . Tot Product Used: 120.Grade Prod Used87 40.0089 40.0093 40.00
Billing Address:
,
Notes:
#3 ALL GRADES MISSING PRICE PRE GALLON
# 4 93 LEAKING HOSE
# 8 PRICE PRE GALLON MISSING TOTAL GALLON NOT READABLE 93 METERCREEPING WHILE PUMPING FUEL
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
Page 235 of 466
Inspector Acknowledged Receipt: SHER SINGH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 236 of 466
Inspector Acknowledged Receipt: SHER SINGH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/6/2011 Business ID: 00114200 Inspection: AU001275Business: COSTCO Store #: #217
9650 W BROAD ST Phone: (804)217-9051Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 24 24Gas Station 1 1Small Capacity Scale 5 5
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B78 PA204200-1 87 1 0 Approved 5.000GILBARCO B78 PA204200-1 93 1 0 Approved 5.000GILBARCO B78 PA204200-2 87 2 0 Approved 5.000GILBARCO B78 PA204200-2 93 2 0 Approved 5.000GILBARCO B78 PA204197-3 87 3 0 Approved 5.000GILBARCO B78 PA204197-3 93 3 0 Approved 5.000GILBARCO B78 PA204197-4 87 4 0 Approved 5.000GILBARCO B78 PA204197-4 93 4 0 Approved 5.000GILBARCO B78 PA204198-5 87 5 0 Approved 5.000GILBARCO B78 PA204198-5 93 5 0 Approved 5.000GILBARCO B78 PA204198-6 87 6 0 Approved 5.000GILBARCO B78 PA204198-6 93 6 0 Approved 5.000GILBARCO B78 PA204202-7 87 7 0 Approved 5.000GILBARCO B78 PA204202-7 93 7 0 Approved 5.000GILBARCO B78 PA204202-8 87 8 0 Approved 5.000GILBARCO B78 PA204202-8 93 8 0 Approved 5.000GILBARCO B78 PA204199-9 87 9 0 Approved 5.000GILBARCO B78 PA204199-9 93 9 0 Approved 5.000GILBARCO B78 PA204199-10 87 10 0 Approved 5.000
Page 237 of 466
Inspector Acknowledged Receipt: DARLENE K CLORE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B78 PA204199-10 93 10 0 Approved 5.000GILBARCO B78 PA204201-11 87 11 0 Approved 5.000GILBARCO B78 PA204201-11 93 11 0 Approved 5.000GILBARCO B78 PA204201-12 87 12 0 Approved 5.000GILBARCO B78 PA204201-12 93 12 0 Approved 5.000
Device Product Used: 120. Insp Product Used: . Tot Product Used: 120.Grade Prod Used87 60.0093 60.00
Billing Address:
,
Notes:
Page 238 of 466
Inspector Acknowledged Receipt: DARLENE K CLORE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/6/2011 Business ID: 00022207 Inspection: AU001276Business: SEIBERTS GASKINS SHELL Store #:
3830 GASKINS RD Phone: (804)346-3040Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 26 26Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NG0 LUEN176611-1 87 1 0 Approved 5.000GILBARCO NG0 LUEN176611-2 87 2 0 Approved 5.000GILBARCO NG1 MUEN176840-6 87 6 0 Approved 5.000GILBARCO NG0 LUEN176611-1 89 1 0 Approved 5.000GILBARCO NG0 LUEN176611-2 89 2 0 Approved 5.000GILBARCO NG1 MUEN176840-6 93 6 0 Approved 5.000GILBARCO NG0 LUEN176611-1 93 1 0 Approved 5.000GILBARCO NG0 LUEN176611-2 93 2 0 Approved 5.000GILBARCO NG1 MUEN176840-5 Diesel 5 0 Approved 5.000GILBARCO NG1 MUEN176840-6 89 6 0 Approved 5.000GILBARCO NG0 LUEN176612-3 87 3 0 Approved 5.000GILBARCO NG0 LUEN176612-3 89 3 0 Approved 5.000GILBARCO NG1 MUEN176840-6 Diesel 6 0 Approved 5.000GILBARCO NG0 LUEN176612-3 93 3 0 Approved 5.000GILBARCO NG0 LUEN176612-4 87 4 0 Approved 5.000GILBARCO NG0 LUEN176612-4 89 4 0 Approved 5.000GILBARCO NG0 LUEN176612-4 93 4 0 Approved 5.000GILBARCO NG0 MUEN179662-7 87 7 0 Approved 5.000GILBARCO NG0 MUEN179662-7 89 7 0 Approved 5.000GILBARCO NG0 MUEN179662-7 93 7 0 Approved 5.000
Page 239 of 466
Inspector Acknowledged Receipt: JOHN GRAHAM
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NG0 MUEN179662-8 87 8 0 Approved 5.000GILBARCO NG0 MUEN179662-8 89 8 0 Approved 5.000GILBARCO NG0 MUEN179662-8 93 8 0 Approved 5.000GILBARCO NG1 MUEN176840-5 87 5 0 Approved 5.000GILBARCO NG1 MUEN176840-5 89 5 0 Approved 5.000GILBARCO NG1 MUEN176840-5 93 5 0 Approved 5.000
Device Product Used: 130. Insp Product Used: . Tot Product Used: 130.Grade Prod Used87 40.0089 40.0093 40.00Diesel 10.00
Billing Address:
,
Notes:
Page 240 of 466
Inspector Acknowledged Receipt: JOHN GRAHAM
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/11/2011 Business ID: 00241108 Inspection: AU001278Business: WAWA Store #: #8605
500 S AIRORT DRIVE Phone: 804-652-1890Inspector: 325 MIKE TILLMAN
SANDSTON, VA 23075 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 48 48Gas Station 1 1Small Capacity Scale 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 072234-1 87 1 0 Approved 5.000GILBARCO NN1 072234-1 89 1 0 Approved 5.000GILBARCO NN1 072234-1 92 1 0 Approved 5.000GILBARCO NN1 072234-2 87 2 0 Approved 5.000GILBARCO NN1 072234-2 89 2 0 Approved 5.000GILBARCO NN1 072234-2 92 2 0 Approved 5.000GILBARCO NN1 072231-3 87 3 0 Approved 5.000GILBARCO NN1 072231-3 89 3 0 Approved 5.000GILBARCO NN1 072231-3 92 3 0 Approved 5.000GILBARCO NN1 072231-4 87 4 0 Approved 5.000GILBARCO NN1 072231-4 89 4 0 Approved 5.000GILBARCO NN1 072231-4 92 4 0 Approved 5.000GILBARCO NN1 072236-5 87 5 0 Approved 5.000GILBARCO NN1 072236-5 89 5 0 Approved 5.000GILBARCO NN1 072236-5 92 5 0 Approved 5.000GILBARCO NN1 072236-6 87 6 0 Approved 5.000GILBARCO NN1 072236-6 89 6 0 Approved 5.000GILBARCO NN1 072236-6 92 6 0 Approved 5.000GILBARCO NN1 072232-7 87 7 0 Approved 5.000
Page 241 of 466
Inspector Acknowledged Receipt: KIM HOLDRIDGE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 072232-7 89 7 0 Approved 5.000GILBARCO NN1 072232-7 92 7 0 Approved 5.000GILBARCO NN1 072232-8 87 8 0 Approved 5.000GILBARCO NN1 072232-8 89 8 0 Approved 5.000GILBARCO NN1 072232-8 92 8 0 Approved 5.000GILBARCO NN1 072237-9 87 9 0 Approved 5.000GILBARCO NN1 072237-9 89 9 0 Approved 5.000GILBARCO NN1 072237-9 92 9 0 Approved 5.000GILBARCO NN1 072237-10 87 10 0 Approved 5.000GILBARCO NN1 072237-10 89 10 0 Approved 5.000GILBARCO NN1 072237-10 92 10 0 Approved 5.000GILBARCO NN1 072235-11 87 11 0 Approved 5.000GILBARCO NN1 072235-11 89 11 0 Approved 5.000GILBARCO NN1 072235-11 92 11 0 Approved 5.000GILBARCO NN1 072235-12 87 12 0 Approved 5.000GILBARCO NN1 072235-12 89 12 0 Approved 5.000GILBARCO NN1 072235-12 92 12 0 Approved 5.000GILBARCO NN1 072233-13 87 13 0 Approved 5.000GILBARCO NN1 072233-13 89 13 0 Approved 5.000GILBARCO NN1 072233-13 92 13 0 Approved 5.000GILBARCO NN1 072233-14 87 14 0 Approved 5.000GILBARCO NN1 072233-14 89 14 0 Approved 5.000GILBARCO NN1 072233-14 92 14 0 Approved 5.000GILBARCO NN1 072238-15 87 15 0 Approved 5.000GILBARCO NN1 072238-15 89 15 0 Approved 5.000GILBARCO NN1 072238-15 92 15 0 Approved 5.000GILBARCO NN1 072238-16 87 16 0 Approved 5.000GILBARCO NN1 072238-16 89 16 0 Approved 5.000GILBARCO NN1 072238-16 92 16 0 Approved 5.000
Device Product Used: 240. Insp Product Used: . Tot Product Used: 240.Grade Prod Used87 80.0089 80.0092 80.00
Page 242 of 466
Inspector Acknowledged Receipt: KIM HOLDRIDGE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Billing Address: WAWA INC.260 W. BALTIMORE PIKE
WAWA, PA 19063
Notes:
Page 243 of 466
Inspector Acknowledged Receipt: KIM HOLDRIDGE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/11/2011 Business ID: 00022542 Inspection: AU001279Business: AIRPORT BP EXPRESS Store #:
5101 S LABURNUM AVE Phone: (804)477-3100Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 32 32Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 HTEN153306-1 87 1 0 Approved 5.000GILBARCO NN1 HTEN153306-1 89 1 0 Approved 5.000GILBARCO NN1 HTEN153306-1 93 1 0 Approved 5.000GILBARCO NN1 HTEN153305-2 87 2 0 Approved 5.000GILBARCO NN1 HTEN153305-2 89 2 0 Approved 5.000GILBARCO NN1 HTEN153305-2 93 2 0 Approved 5.000GILBARCO NN1 HTEN153306-3 87 3 0 Approved 5.000GILBARCO NN1 HTEN153306-3 89 3 0 Approved 5.000GILBARCO NN1 HTEN153306-3 93 3 0 Approved 5.000GILBARCO NN1 HTEN153305-4 87 4 0 Approved 5.000GILBARCO NN1 HTEN153305-4 89 4 0 Approved 5.000GILBARCO NN1 HTEN153305-4 93 4 0 Approved 5.000GILBARCO NN1 HTEN153308-5 87 5 0 Approved 5.000GILBARCO NN1 HTEN153308-5 89 5 0 Approved 5.000GILBARCO NN1 HTEN153308-5 93 5 0 Approved 5.000GILBARCO NN1 HTEN153307-6 87 6 0 Approved 5.000GILBARCO NN1 HTEN153307-6 89 6 0 Approved 5.000GILBARCO NN1 HTEN153307-6 93 6 0 Approved 5.000GILBARCO NN1 HTEN153308-7 87 7 0 Approved 5.000GILBARCO NN1 HTEN153308-7 89 7 0 Approved 5.000
Page 244 of 466
Inspector Acknowledged Receipt: ARVIND PATEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 HTEN153308-7 93 7 0 Approved 5.000GILBARCO NN1 HTEN153307-8 87 8 0 Approved 5.000GILBARCO NN1 HTEN153307-8 89 8 0 Approved 5.000GILBARCO NN1 HTEN153307-8 93 8 0 Approved 5.000GILBARCO NL1 HTEN153309-9 87 9 0 Approved 5.000GILBARCO NL1 HTEN153309-9 89 9 0 Approved 5.000GILBARCO NL1 HTEN153309-9 93 9 0 Approved 5.000GILBARCO NL1 HTEN153309-9 Diesel 9 0 Approved 5.000GILBARCO NL1 HTEN153309-10 87 10 0 Approved 5.000GILBARCO NL1 HTEN153309-10 89 10 0 Approved 5.000GILBARCO NL1 HTEN153309-10 93 10 0 Approved 5.000GILBARCO NL1 HTEN153309-10 Diesel 10 0 Approved 5.000
Device Product Used: 160. Insp Product Used: . Tot Product Used: 160.Grade Prod Used87 50.0089 50.0093 50.00Diesel 10.00
Billing Address:
,
Notes:
Page 245 of 466
Inspector Acknowledged Receipt: ARVIND PATEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/13/2011 Business ID: 00110881 Inspection: AU001281Business: WAWA Store #: #677
8800 BROOK RD Phone: 804-264-4698Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
07/13/11 01:02 PM 01:25 PM 0:23 0:00 0:23 C-8889 NO PROBLEM FOUNDTotal: 0:23 0:00 0:23
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA225209-15 87 15 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 246 of 466
Inspector Acknowledged Receipt: PEDRO VAZQUEZH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/14/2011 Business ID: 00500704 Inspection: AU001282Business: VARAINA CONVENIENCE STORE INC. Store #:
3275 NEW MARKET RD Phone: 804-795-4213Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 52 35 11 6Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NL1 EN-007434-1 87 1 0 Approved 5.000GILBARCO NL1 EN-007434-1 89 1 0 Approved 5.000GILBARCO NL1 EN-007434-2 89 2 -4 Approved 5.000GILBARCO NL1 EN-007433-3 89 3 0 Approved 5.000GILBARCO NL1 EN-007434-1 93 1 0 Approved 5.000GILBARCO NL1 EN-007433-4 89 4 2 Approved 5.000GILBARCO NL1 EN-007434-1 Diesel 1 3 Approved 5.000GILBARCO NL1 EN-007434-2 87 2 0 Approved 5.000GILBARCO NN1 EN-007439-6 89 6 0 Rejected 5.000GILBARCO NN1 EN-007435-10 89 10 0 Rejected 5.000GILBARCO NN1 EN-007438-8 89 8 0 Rejected 5.000GILBARCO NL1 EN-007434-2 93 2 -4 Approved 5.000GILBARCO NN1 EN-007436-12 89 12 -4 Rejected 5.000GILBARCO NL1 EN-007434-2 Diesel 2 0 Approved 5.000GILBARCO NN1 EN-007437-15 89 15 0 Not Tested 0.000GILBARCO NL1 EN-007433-3 87 3 -3 Approved 5.000GILBARCO NN1 EN-007437-16 89 16 0 Not Tested 0.000GILBARCO NN1 EN-007440-13 87 13 -10 Rejected 5.000GILBARCO NN1 EN-007440-13 89 13 0 Approved 5.000GILBARCO NL1 EN-007433-3 93 3 2 Approved 5.000
Page 247 of 466
Inspector Acknowledged Receipt: SIERRA BARNES
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 EN-007440-13 93 13 0 Approved 5.000GILBARCO NL1 EN-007433-3 Diesel 3 0 Approved 5.000GILBARCO NL1 EN-007433-4 87 4 3 Approved 5.000GILBARCO NL1 EN-007433-4 93 4 -6 Approved 5.000GILBARCO NL1 EN-007433-4 Diesel 4 0 Approved 5.000GILBARCO NN1 EN-007439-5 87 5 -2 Approved 5.000GILBARCO NN1 EN-007439-5 89 5 5 Approved 5.000GILBARCO NN1 EN-007439-5 93 5 2 Approved 5.000GILBARCO NN1 EN-007439-6 87 6 2 Approved 5.000GILBARCO NN1 EN-007439-6 93 6 3 Approved 5.000GILBARCO NN1 EN-007438-7 87 7 3 Approved 5.000GILBARCO NN1 EN-007438-7 89 7 6 Approved 5.000GILBARCO NN1 EN-007438-7 93 7 2 Approved 5.000GILBARCO NN1 EN-007438-8 87 8 0 Approved 5.000GILBARCO NN1 EN-007438-8 93 8 0 Approved 5.000GILBARCO NN1 EN-007435-9 87 9 3 Approved 5.000GILBARCO NN1 EN-007435-9 89 9 10 Rejected 5.000GILBARCO NN1 EN-007435-9 93 9 6 Approved 5.000GILBARCO NN1 EN-007435-10 87 10 2 Approved 5.000GILBARCO NN1 EN-007435-10 93 10 -6 Approved 5.000GILBARCO NN1 EN-007436-11 87 11 -3 Approved 5.000GILBARCO NN1 EN-007436-11 89 11 13 Rejected 5.000GILBARCO NN1 EN-007436-11 93 11 9 Rejected 5.000GILBARCO NN1 EN-007436-12 87 12 -3 Rejected 5.000GILBARCO NN1 EN-007436-12 93 12 -5 Rejected 5.000GILBARCO NN1 EN-007440-14 87 14 0 Approved 5.000GILBARCO NN1 EN-007440-14 89 14 20 Rejected 5.000GILBARCO NN1 EN-007440-14 93 14 0 Approved 5.000GILBARCO NN1 EN-007437-15 87 15 0 Not Tested 0.000GILBARCO NN1 EN-007437-15 93 15 0 Not Tested 0.000GILBARCO NN1 EN-007437-16 87 16 0 Not Tested 0.000GILBARCO NN1 EN-007437-16 93 16 0 Not Tested 0.000
Device Product Used: 230. Insp Product Used: . Tot Product Used: 230.Grade Prod Used87 70.00
Page 248 of 466
Inspector Acknowledged Receipt: SIERRA BARNES
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
89 70.0093 70.00Diesel 20.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571
Page 249 of 466
Inspector Acknowledged Receipt: SIERRA BARNES
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 250 of 466
Inspector Acknowledged Receipt: SIERRA BARNES
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/14/2011 Business ID: 00113717 Inspection: AU001283Business: FAS MART Store #: #40
2650 NEW MARKET RD Phone: (804)730-1568Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 27 27Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 GNEN0537-1 87 1 0 Approved 5.000GILBARCO NN1 GNEN0537-1 89 1 0 Approved 5.000GILBARCO NN1 GNEN0537-1 93 1 0 Approved 5.000GILBARCO NN1 GNEN0537-2 87 2 0 Approved 5.000GILBARCO NN1 GNEN0537-2 89 2 0 Approved 5.000GILBARCO NN1 GNEN0537-2 93 2 0 Approved 5.000GILBARCO NN1 GNEN0537-3 87 3 0 Approved 5.000GILBARCO NN1 GNEN0537-3 89 3 0 Approved 5.000GILBARCO NN1 GNEN0537-3 93 3 0 Approved 5.000GILBARCO NN1 GNEN0537-4 87 4 0 Approved 5.000GILBARCO NN1 GNEN0537-4 89 4 0 Approved 5.000GILBARCO NN1 GNEN0537-4 93 4 0 Approved 5.000GILBARCO NN1 GNEN0537-5 87 5 0 Approved 5.000GILBARCO NN1 GNEN0537-5 89 5 0 Approved 5.000GILBARCO NN1 GNEN0537-5 93 5 0 Approved 5.000GILBARCO NN1 GNEN0537-6 87 6 0 Approved 5.000GILBARCO NN1 GNEN0537-6 89 6 0 Approved 5.000GILBARCO NN1 GNEN0537-6 93 6 0 Approved 5.000GILBARCO NL1 GNEN0537-7 87 7 0 Approved 5.000GILBARCO NL1 GNEN0537-7 89 7 0 Approved 5.000
Page 251 of 466
Inspector Acknowledged Receipt: RHIANNON PLEASANTS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NL1 GNEN0537-7 93 7 0 Approved 5.000GILBARCO NL1 GNEN0537-7 Diesel 7 0 Approved 5.000GILBARCO NL1 GNEN0537-8 87 8 0 Approved 5.000GILBARCO NL1 GNEN0537-8 89 8 0 Approved 5.000GILBARCO NL1 GNEN0537-8 93 8 0 Approved 5.000GILBARCO NL1 GNEN0537-8 Diesel 8 0 Approved 5.000GILBARCO JH000 FNLA07390 Kerosene 9 0 Approved 5.000
Device Product Used: 135. Insp Product Used: . Tot Product Used: 135.Grade Prod Used87 40.0089 40.0093 40.00Diesel 10.00Kerosene 5.00
Billing Address:
,
Notes:
Page 252 of 466
Inspector Acknowledged Receipt: RHIANNON PLEASANTS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/15/2011 Business ID: 00021473 Inspection: AU001284Business: FAST STOP 1 Store #:
2301 MECHANICSVILLE TNPK Phone: (804)782-9326Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 32 22 9 1Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B05 PAO37481-1 87 1 0 Approved 5.000GILBARCO B05 PAO37481-1 89 1 0 Approved 5.000GILBARCO B05 PA037478-12 89 12 0 Approved 5.000GILBARCO B05 PA037483-5 Diesel 5 0 Rejected 5.000GILBARCO B05 PAO37481-1 93 1 0 Approved 5.000GILBARCO B05 PAO37481-2 87 2 0 Approved 5.000GILBARCO B05 PAO37481-2 89 2 0 Condemned 5.000GILBARCO B05 PAO37481-2 93 2 0 Approved 5.000GILBARCO B05 PA037482-3 87 3 0 Approved 5.000GILBARCO B05 PA037482-3 89 3 0 Approved 5.000GILBARCO B05 PA037482-3 93 3 0 Approved 5.000GILBARCO B05 PA037482-4 87 4 0 Rejected 5.000GILBARCO B05 PA037482-4 89 4 0 Approved 5.000GILBARCO B05 PA037482-4 93 4 0 Rejected 0.000GILBARCO B05 PA037479-7 87 7 0 Approved 5.000GILBARCO B05 PA037479-7 89 7 0 Approved 5.000GILBARCO B05 PA037479-7 93 7 0 Approved 5.000GILBARCO B05 PA037479-8 87 8 0 Rejected 5.000GILBARCO B05 PA037479-8 89 8 0 Rejected 5.000GILBARCO B05 PA037479-8 93 8 0 Approved 5.000
Page 253 of 466
Inspector Acknowledged Receipt: meseret
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B05 PA037480-9 87 9 0 Approved 5.000GILBARCO B05 PA037480-9 89 9 0 Approved 5.000GILBARCO B05 PA037480-9 93 9 0 Approved 5.000GILBARCO B05 PA037480-10 87 10 0 Rejected 5.000GILBARCO B05 PA037480-10 89 10 0 Approved 5.000GILBARCO B05 PA037480-10 93 10 0 Approved 5.000GILBARCO B05 PA037478-11 87 11 0 Rejected 5.000GILBARCO B05 PA037478-11 89 11 0 Rejected 5.000GILBARCO B05 PA037478-11 93 11 0 Rejected 5.000GILBARCO B05 PA037478-12 87 12 0 Approved 5.000GILBARCO B05 PA037478-12 93 12 0 Approved 5.000GILBARCO B05 PA037483-6 Diesel 6 0 Approved 5.000
Device Product Used: 155. Insp Product Used: . Tot Product Used: 155.Grade Prod Used87 50.0089 50.0093 45.00Diesel 10.00
Billing Address:
,
Notes:
pump # 11 missing ethanol labelpump # 8 89 missing octane label 87 meter creeping at startuppump # 10 87 auto shutoff not workingpump# 4 missing 87 octane label pump # 5 customer display
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 254 of 466
Inspector Acknowledged Receipt: meseret
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 255 of 466
Inspector Acknowledged Receipt: meseret
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/18/2011 Business ID: 00111773 Inspection: AU001285Business: FRENDLY QUICK MART CITGO Store #:
1290 N LABURNUM AVE Phone: (804)788-1328Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 24 21 3Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B85 PA182205-1 87 1 0 Approved 5.000GILBARCO B85 PA182205-1 89 1 0 Approved 5.000GILBARCO B85 PA182205-1 93 1 0 Approved 5.000GILBARCO B85 PA182205-2 87 2 0 Approved 5.000GILBARCO B85 PA182205-2 89 2 0 Approved 5.000GILBARCO B85 PA182205-2 93 2 0 Approved 5.000GILBARCO B85 PA182203-3 87 3 0 Approved 5.000GILBARCO B85 PA182203-3 89 3 0 Approved 5.000GILBARCO B85 PA182203-3 93 3 0 Approved 5.000GILBARCO B85 PA182203-4 87 4 0 Rejected 0.000GILBARCO B85 PA182203-4 89 4 0 Rejected 0.000GILBARCO B85 PA182203-4 93 4 0 Rejected 0.000GILBARCO B85 PA182204-5 87 5 0 Approved 5.000GILBARCO B85 PA182204-5 89 5 0 Approved 5.000GILBARCO B85 PA182204-5 93 5 0 Approved 5.000GILBARCO B85 PA182204-6 87 6 0 Approved 5.000GILBARCO B85 PA182204-6 89 6 0 Approved 5.000GILBARCO B85 PA182204-6 93 6 0 Approved 5.000GILBARCO B85 PA182202-7 87 7 0 Approved 5.000GILBARCO B85 PA182202-7 89 7 0 Approved 5.000
Page 256 of 466
Inspector Acknowledged Receipt: HASAN RAHMAN'
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B85 PA182202-7 93 7 0 Approved 5.000GILBARCO B85 PA182202-8 87 8 0 Approved 5.000GILBARCO B85 PA182202-8 89 8 0 Approved 5.000GILBARCO B85 PA182202-8 93 8 0 Approved 5.000
Device Product Used: 105. Insp Product Used: . Tot Product Used: 105.Grade Prod Used87 35.0089 35.0093 35.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service
Page 257 of 466
Inspector Acknowledged Receipt: HASAN RAHMAN'
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 258 of 466
Inspector Acknowledged Receipt: HASAN RAHMAN'
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/18/2011 Business ID: 00021574 Inspection: AU001286Business: NEW MARKET CONVENIENCE Store #:
1130 NEW MARKET RD Phone: (804)222-7767Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 24 24Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO RB78 16765-1 87 1 0 Approved 5.000GILBARCO RB78 16765-1 89 1 0 Approved 5.000GILBARCO RB78 16765-1 93 1 0 Approved 5.000GILBARCO RB78 16765-2 87 2 0 Approved 5.000GILBARCO RB78 16765-2 89 2 0 Approved 5.000GILBARCO RB78 16765-2 93 2 0 Approved 5.000GILBARCO RB78 16766-3 87 3 0 Approved 5.000GILBARCO RB78 16766-3 89 3 0 Approved 5.000GILBARCO RB78 16766-3 93 3 0 Approved 5.000GILBARCO RB78 16766-4 87 4 0 Approved 5.000GILBARCO RB78 16766-4 89 4 0 Approved 5.000GILBARCO RB78 16766-4 93 4 0 Approved 5.000GILBARCO RB78 16767-5 87 5 0 Approved 5.000GILBARCO RB78 16767-5 89 5 0 Approved 5.000GILBARCO RB78 16767-5 93 5 0 Approved 5.000GILBARCO RB78 16767-6 87 6 0 Approved 5.000GILBARCO RB78 16767-6 89 6 0 Approved 5.000GILBARCO RB78 16767-6 93 6 0 Approved 5.000GILBARCO RB78 16768-7 87 7 0 Approved 5.000GILBARCO RB78 16768-7 89 7 0 Approved 5.000
Page 259 of 466
Inspector Acknowledged Receipt: ELBERT BEST
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO RB78 16768-7 93 7 0 Approved 5.000GILBARCO RB78 16768-8 87 8 0 Approved 5.000GILBARCO RB78 16768-8 89 8 0 Approved 5.000GILBARCO RB78 16768-8 93 8 0 Approved 5.000
Device Product Used: 120. Insp Product Used: . Tot Product Used: 120.Grade Prod Used87 40.0089 40.0093 40.00
Billing Address:
,
Notes:
Page 260 of 466
Inspector Acknowledged Receipt: ELBERT BEST
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/21/2011 Business ID: 00501021 Inspection: AU001287Business: WAWA Store #: 8617
11052 W. BROAD Phone: 804-527-8302Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
07/21/11 09:13 AM 09:38 AM 0:25 0:00 0:25 C-8912 NO PROBLEM FOUNDTotal: 0:25 0:00 0:25
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 LUEN177265-12 87 12 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 261 of 466
Inspector Acknowledged Receipt: RON RUSSAKOFF
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/25/2011 Business ID: 00113936 Inspection: AU001301Business: 7-ELEVEN Store #: #32970
900 E PARHAM RD Phone: 804-515-9310Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 24 24Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA225960-1 87 1 0 Approved 5.000GILBARCO B79 PA225960-1 89 1 0 Approved 5.000GILBARCO B79 PA225960-1 93 1 0 Approved 5.000GILBARCO B79 PA225960-2 87 2 0 Approved 5.000GILBARCO B79 PA225960-2 89 2 0 Approved 5.000GILBARCO B79 PA225960-2 93 2 0 Approved 5.000GILBARCO B79 PA225959-3 87 3 0 Approved 5.000GILBARCO B79 PA225959-3 89 3 0 Approved 5.000GILBARCO B79 PA225959-3 93 3 0 Approved 5.000GILBARCO B79 PA225595-4 87 4 0 Approved 5.000GILBARCO B79 PA225595-4 89 4 0 Approved 5.000GILBARCO B79 PA225595-4 93 4 0 Approved 5.000GILBARCO B79 PA225962-5 87 5 0 Approved 5.000GILBARCO B79 PA225962-5 89 5 0 Approved 5.000GILBARCO B79 PA225962-5 93 5 0 Approved 5.000GILBARCO B79 PA225962-6 87 6 0 Approved 5.000GILBARCO B79 PA225962-6 89 6 0 Approved 5.000GILBARCO B79 PA225962-6 93 6 0 Approved 5.000GILBARCO B79 PA225961-7 87 7 0 Approved 5.000GILBARCO B79 PA225961-7 89 7 0 Approved 5.000
Page 262 of 466
Inspector Acknowledged Receipt: TAMMY ALLEN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA225961-7 93 7 0 Approved 5.000GILBARCO B79 PA225061-8 87 8 0 Approved 5.000GILBARCO B79 PA225061-8 89 8 0 Approved 5.000GILBARCO B79 PA225061-8 93 8 0 Approved 5.000
Device Product Used: 120. Insp Product Used: . Tot Product Used: 120.Grade Prod Used87 40.0089 40.0093 40.00
Billing Address:
,
Notes:
Page 263 of 466
Inspector Acknowledged Receipt: TAMMY ALLEN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/25/2011 Business ID: 00110881 Inspection: AU001302Business: WAWA Store #: #677
8800 BROOK RD Phone: 804-264-4698Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
07/25/11 11:00 AM 11:19 AM 0:19 0:00 0:19 c-8920 no problem foundTotal: 0:19 0:00 0:19
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA225213-13 87 13 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 264 of 466
Inspector Acknowledged Receipt: NIKKI MARTZ
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/25/2011 Business ID: 00021711 Inspection: AU001303Business: LIBBIE PLACE BP Store #:
5801 W BROAD ST Phone: (804)282-8022Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23230 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 26 26Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 JSEN134496-1 87 1 0 Approved 5.000GILBARCO NN1 JSEN134496-2 87 2 0 Approved 5.000GILBARCO NN1 JSEN134496-2 93 2 0 Approved 5.000GILBARCO NN1 JSEN134496-1 89 1 0 Approved 5.000GILBARCO NN1 JSEN134496-2 89 2 0 Approved 5.000GILBARCO NN1 JSEN134496-1 93 1 0 Approved 5.000GILBARCO NN1 JSEN134498-3 87 3 0 Approved 5.000GILBARCO NN1 JSEN134498-3 89 3 0 Approved 5.000GILBARCO NN1 JSEN134498-3 93 3 0 Approved 5.000GILBARCO NN1 JSEN134498-4 87 4 0 Approved 5.000GILBARCO NN1 JSEN134498-4 89 4 0 Approved 5.000GILBARCO NN1 JSEN134498-4 93 4 0 Approved 5.000GILBARCO NN1 JSEN134497-5 87 5 0 Approved 5.000GILBARCO NN1 JSEN134497-5 89 5 0 Approved 5.000GILBARCO NN1 JSEN134497-5 93 5 0 Approved 5.000GILBARCO NN1 JSEN134497-6 87 6 0 Approved 5.000GILBARCO NN1 JSEN134497-6 89 6 0 Approved 5.000GILBARCO NN1 JSEN134497-6 93 6 0 Approved 5.000GILBARCO NL1 JSEN134499-7 87 7 0 Approved 5.000GILBARCO NL1 JSEN134499-7 89 7 0 Approved 5.000
Page 265 of 466
Inspector Acknowledged Receipt: RONNIE PLOTKIN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NL1 JSEN134499-7 93 7 0 Approved 5.000GILBARCO NL1 JSEN134499-7 Diesel 7 0 Approved 5.000GILBARCO NL1 JSEN134499-8 87 8 0 Approved 5.000GILBARCO NL1 JSEN134499-8 89 8 0 Approved 5.000GILBARCO NL1 JSEN134499-8 93 8 0 Approved 5.000GILBARCO NL1 JSEN134499-8 Diesel 8 0 Approved 5.000
Device Product Used: 130. Insp Product Used: . Tot Product Used: 130.Grade Prod Used87 40.0089 40.0093 40.00Diesel 10.00
Billing Address:
,
Notes:
Page 266 of 466
Inspector Acknowledged Receipt: RONNIE PLOTKIN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/26/2011 Business ID: 00161991 Inspection: AU001304Business: QUICK TRIP Store #:
510 E LABURNUM AVE Phone: (804)321-7864Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 18 15 3Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 CTEN151866-1 87 1 0 Condemned 5.000GILBARCO NN1 CTEN151866-1 89 1 0 Condemned 5.000GILBARCO NN1 CTEN151866-1 93 1 0 Condemned 5.000GILBARCO NN1 CTEN151866-2 87 2 0 Approved 5.000GILBARCO NN1 CTEN151866-2 89 2 0 Approved 5.000GILBARCO NN1 CTEN151866-2 93 2 0 Approved 5.000GILBARCO NN1 CTEN151863-3 87 3 0 Approved 5.000GILBARCO NN1 CTEN151863-3 89 3 0 Approved 5.000GILBARCO NN1 CTEN151863-3 93 3 0 Approved 5.000GILBARCO NN1 CTEN151864-4 87 4 0 Approved 5.000GILBARCO NN1 CTEN151864-4 89 4 0 Approved 5.000GILBARCO NN1 CTEN151864-4 93 4 0 Approved 5.000GILBARCO NN1 CTEN151865-5 87 5 0 Approved 5.000GILBARCO NN1 CTEN151865-5 89 5 0 Approved 5.000GILBARCO NN1 CTEN151865-5 93 5 0 Approved 5.000GILBARCO NN1 CTEN151865-6 87 6 0 Approved 5.000GILBARCO NN1 CTEN151865-6 89 6 0 Approved 5.000GILBARCO NN1 CTEN151865-6 93 6 0 Approved 5.000
Device Product Used: 90. Insp Product Used: . Tot Product Used: 90.
Page 267 of 466
Inspector Acknowledged Receipt:
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Grade Prod Used87 30.0089 30.0093 30.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
Page 268 of 466
Inspector Acknowledged Receipt:
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 269 of 466
Inspector Acknowledged Receipt:
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/26/2011 Business ID: 00113982 Inspection: AU001305Business: 7-ELEVEN Store #: #25240
1 E LABURNUM AVE Phone: 804-329-8184Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23222 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 8 8Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B05 PAO74489-1 87 1 0 Approved 5.000GILBARCO B05 PAO74489-1 89 1 0 Approved 5.000GILBARCO B05 PA074489-2 87 2 0 Approved 5.000GILBARCO B05 PA074489-2 89 2 0 Approved 5.000GILBARCO B05 PA074488-3 87 3 0 Approved 5.000GILBARCO B05 PA074488-3 89 3 0 Approved 5.000GILBARCO B05 PAO74488-4 87 4 0 Approved 5.000GILBARCO B05 PAO74488-4 89 4 0 Approved 5.000
Device Product Used: 40. Insp Product Used: . Tot Product Used: 40.Grade Prod Used87 20.0089 20.00
Billing Address:
,
Page 270 of 466
Inspector Acknowledged Receipt: Natalie Tolliver
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Notes:
Not selling 93 at this time
Page 271 of 466
Inspector Acknowledged Receipt: Natalie Tolliver
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/26/2011 Business ID: 00113656 Inspection: AU001306Business: FAS MART Store #: #88
338-A E WILLIAMSBURG RD Phone: (804)3281071Inspector: 325 MIKE TILLMAN
SANDSTON, VA 23150 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 18 18Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B65 166421-1 87 1 0 Approved 5.000GILBARCO B65 166423-4 87 4 0 Approved 5.000GILBARCO B65 166421-1 89 1 0 Approved 5.000GILBARCO B65 166421-1 93 1 0 Approved 5.000GILBARCO B65 166421-2 87 2 0 Approved 5.000GILBARCO B65 166421-2 89 2 0 Approved 5.000GILBARCO B65 166421-2 93 2 0 Approved 5.000GILBARCO B65 166423-3 87 3 0 Approved 5.000GILBARCO B65 166423-3 89 3 0 Approved 5.000GILBARCO B65 166423-3 93 3 0 Approved 5.000GILBARCO B65 166423-4 89 4 0 Approved 5.000GILBARCO B65 166423-4 93 4 0 Approved 5.000GILBARCO B65 166422-5 87 5 0 Approved 5.000GILBARCO B65 166422-5 89 5 0 Approved 5.000GILBARCO B65 166422-5 93 5 0 Approved 5.000GILBARCO B65 166422-6 87 6 0 Approved 5.000GILBARCO B65 166422-6 89 6 0 Approved 5.000GILBARCO B65 166422-6 93 6 0 Approved 5.000
Device Product Used: 90. Insp Product Used: . Tot Product Used: 90.
Page 272 of 466
Inspector Acknowledged Receipt: KEAUNA D. ROZIER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Grade Prod Used87 30.0089 30.0093 30.00
Billing Address: GMP1 LLC.7443 LEE DAVIS RD.804-730-1568MECH., VA 23111
Notes:
Page 273 of 466
Inspector Acknowledged Receipt: KEAUNA D. ROZIER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/1/2011 Business ID: 00021927 Inspection: AU001312Business: HANDI STOP DELI Store #:
17-B HANOVER RD Phone: (804)737-8524Inspector: 325 MIKE TILLMAN
SANDSTON, VA 23150 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 14 4 10Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B23 4223D1/JK-1 87 #1 0 Rejected 0.000WAYNE B23 4223D1/JK-1 Diesel #1 0 Rejected 0.000WAYNE B23 4223D1/JK-1 89 #1 0 Rejected 0.000WAYNE B23 4223D1/JK-2 Diesel #2 0 Approved 0.000WAYNE B12 3223D1/JK-4 87 #4 0 Rejected 0.000WAYNE B23 4223D1/JK-1 93 #1 0 Rejected 0.000WAYNE B12 3223D1/JK-4 89 #4 0 Rejected 0.000WAYNE B12 3223D1/JK-4 93 #4 0 Rejected 0.000WAYNE B23 4223D1/JK-2 87 #2 0 Approved 0.000WAYNE B23 4223D1/JK-2 89 #2 0 Approved 0.000WAYNE B23 4223D1/JK-2 93 #2 0 Approved 0.000WAYNE B12 3223D1/JK-3 87 #3 0 Rejected 0.000WAYNE B12 3223D1/JK-3 89 #3 0 Rejected 0.000WAYNE B12 3223D1/JK-3 93 #3 0 Rejected 0.000
Billing Address:
,
Page 274 of 466
Inspector Acknowledged Receipt: D H SHAH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Notes:
PUMP # 1,3,& 4 PRICE PER GALLON NOT READABLE
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. Penalties
Page 275 of 466
Inspector Acknowledged Receipt: D H SHAH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
A. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 276 of 466
Inspector Acknowledged Receipt: D H SHAH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/1/2011 Business ID: 00022105 Inspection: AU001313Business: FAIRFIELD BP Store #:
5051 NINE MILE RD Phone: (804)737-7611Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
08/01/11 10:59 AM 11:35 AM 0:36 0:00 0:36 C-8929 MEETER CREEPING AT END OF SALETotal: 0:36 0:00 0:36
Class Actv App Rej Con CwC NTLiquid Measuring Device 2 2
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE DL335901LGO 602421-1 87 1 0 Condemned 5.000WAYNE DL335901LGO 602423-3 87 3 0 Condemned 5.000
Device Product Used: 10. Insp Product Used: . Tot Product Used: 10.Grade Prod Used87 10.00
Billing Address:
,
Notes:
MEETER CREEPING AT END OF SALE
Page 277 of 466
Inspector Acknowledged Receipt: HARSHA PANCHASARA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Page 278 of 466
Inspector Acknowledged Receipt: HARSHA PANCHASARA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 279 of 466
Inspector Acknowledged Receipt: HARSHA PANCHASARA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/1/2011 Business ID: 00114014 Inspection: AU001314Business: 7-ELEVEN Store #: #22719
3600 MECHANICSVILLE TNPK Phone: 804-321-1828Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 12 12Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B65 PAO63841-1 87 1 0 Approved 6.000GILBARCO B65 PAO63841-1 89 1 0 Approved 5.000GILBARCO B65 PAO63841-1 93 1 0 Approved 5.000GILBARCO B65 PAO63841-2 87 2 0 Approved 5.000GILBARCO B65 PAO63841-2 89 2 0 Approved 5.000GILBARCO B65 PAO63841-2 93 2 0 Approved 5.000GILBARCO B65 PAO63842-3 87 3 0 Approved 5.000GILBARCO B65 PAO63842-3 89 3 0 Approved 5.000GILBARCO B65 PAO63842-3 93 3 0 Approved 5.000GILBARCO B65 PAO63842-4 87 4 0 Approved 5.000GILBARCO B65 PAO63842-4 89 4 0 Approved 5.000GILBARCO B65 PAO63842-4 93 4 0 Approved 5.000
Device Product Used: 61. Insp Product Used: . Tot Product Used: 61.Grade Prod Used87 21.0089 20.0093 20.00
Page 280 of 466
Inspector Acknowledged Receipt: MONICA BARNETT
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Billing Address:
,
Notes:
Page 281 of 466
Inspector Acknowledged Receipt: MONICA BARNETT
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/1/2011 Business ID: 00022364 Inspection: AU001315Business: CHAMBERLAYNE FARMS SUNOCO Store #:
214 WILKINSON RD Phone: (804)261-4017Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23227 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 12 12Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE DL1/3901L/GQ 629402-1 87 1 0 Approved 5.000WAYNE DL1/3901L/GQ 629402-1 89 1 0 Approved 5.000WAYNE DL1/3901L/GQ 629402-1 93 1 0 Approved 5.000WAYNE DL1/3901L/GQ 629402-2 87 2 0 Approved 5.000WAYNE DL1/3901L/GQ 629402-2 89 2 0 Approved 5.000WAYNE DL1/3901L/GQ 629402-2 93 2 0 Approved 5.000WAYNE DL1/3901L/GQ 629403-3 87 3 0 Approved 5.000WAYNE DL1/3901L/GQ 629403-3 89 3 0 Approved 5.000WAYNE DL1/3901L/GQ 629403-3 93 3 0 Approved 5.000WAYNE DL1/3901L/GQ 629403-4 87 4 0 Approved 5.000WAYNE DL1/3901L/GQ 629403-4 89 4 0 Approved 5.000WAYNE DL1/3901L/GQ 629403-4 93 4 0 Approved 5.000
Device Product Used: 60. Insp Product Used: . Tot Product Used: 60.Grade Prod Used87 20.0089 20.0093 20.00
Page 282 of 466
Inspector Acknowledged Receipt: STEVE MONTALBANO
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Billing Address:
,
Notes:
Page 283 of 466
Inspector Acknowledged Receipt: STEVE MONTALBANO
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/16/2011 Business ID: 00500704 Inspection: AU001373Business: VARAINA CONVENIENCE STORE INC. Store #:
3275 NEW MARKET RD Phone: 804-795-4213Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 17 14 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 EN-007439-6 89 6 0 Approved 0.000GILBARCO NN1 EN-007435-10 89 10 0 Approved 0.000GILBARCO NN1 EN-007438-8 89 8 0 Approved 0.000GILBARCO NN1 EN-007436-12 89 12 0 Approved 0.000GILBARCO NN1 EN-007437-15 89 15 0 Condemned 0.000GILBARCO NN1 EN-007437-16 89 16 0 Approved 5.000GILBARCO NN1 EN-007440-13 87 13 0 Approved 5.000GILBARCO NN1 EN-007435-9 89 9 0 Approved 5.000GILBARCO NN1 EN-007436-11 89 11 0 Approved 5.000GILBARCO NN1 EN-007436-11 93 11 0 Approved 5.000GILBARCO NN1 EN-007436-12 87 12 0 Approved 0.000GILBARCO NN1 EN-007436-12 93 12 0 Approved 0.000GILBARCO NN1 EN-007440-14 89 14 0 Approved 5.000GILBARCO NN1 EN-007437-15 87 15 0 Condemned 0.000GILBARCO NN1 EN-007437-15 93 15 0 Condemned 0.000GILBARCO NN1 EN-007437-16 87 16 0 Approved 5.000GILBARCO NN1 EN-007437-16 93 16 0 Approved 5.000
Device Product Used: 40. Insp Product Used: . Tot Product Used: 40.Grade Prod Used87 10.00
Page 284 of 466
Inspector Acknowledged Receipt: SIERRA BARNES
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
89 20.0093 10.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571
Page 285 of 466
Inspector Acknowledged Receipt: SIERRA BARNES
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 286 of 466
Inspector Acknowledged Receipt: SIERRA BARNES
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/16/2011 Business ID: 00021927 Inspection: AU001374Business: HANDI STOP DELI Store #:
17-B HANOVER RD Phone: (804)737-8524Inspector: 325 MIKE TILLMAN
SANDSTON, VA 23150 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
08/16/11 02:23 PM 02:48 PM 0:25 0:00 0:25 C-8977 NO PROLEM FOUNDTotal: 0:25 0:00 0:25
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B12 3223D1/JK-4 93 #4 0 Approved 0.000
Billing Address:
,
Notes:
Page 287 of 466
Inspector Acknowledged Receipt: D H SHAH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/18/2011 Business ID: 00163583 Inspection: AU001377Business: NORTH PARK SHELL Store #: #10
805 PARHAM RD Phone: 804-266-4407Inspector: 325 MIKE TILLMAN
RICHM0ND, VA 23227 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B78 PA141848-12 87 12 0Condemned w/Control
0.000
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
Page 288 of 466
Inspector Acknowledged Receipt: TIFFANY BAKERB
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 289 of 466
Inspector Acknowledged Receipt: TIFFANY BAKERB
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/18/2011 Business ID: 00112911 Inspection: AU001379Business: STAPLES MILL SHELL Store #: #116954
6001 STAPLES MILL RD Phone: (804)264-1900Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 16 16
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 2/595D4 722340-3 87 3 0 Approved 0.000WAYNE 2/595D4 722340-3 89 3 0 Approved 0.000WAYNE 2/595D4 722340-3 93 3 0 Approved 0.000WAYNE 2/595D4 722340-3 Diesel 3 0 Approved 0.000WAYNE 2/595D4 722340-4 87 4 0 Approved 0.000WAYNE 2/595D4 722340-4 89 4 0 Approved 0.000WAYNE 2/595D4 722340-4 93 4 0 Approved 0.000WAYNE 2/595D4 722340-4 Diesel 4 0 Approved 0.000WAYNE 2/595D4 734995-11 87 11 0 Approved 0.000WAYNE 2/595D4 734995-11 89 11 0 Approved 0.000WAYNE 2/595D4 734995-11 93 11 0 Approved 0.000WAYNE 2/595D4 734995-11 Diesel 11 0 Approved 0.000WAYNE 2/595D4 733995-12 87 12 0 Approved 0.000WAYNE 2/595D4 733995-12 89 12 0 Approved 0.000WAYNE 2/595D4 733995-12 93 12 0 Approved 0.000WAYNE 2/595D4 733995-12 Diesel 12 -1 Approved 1.000
Device Product Used: 1. Insp Product Used: . Tot Product Used: 1.Grade Prod UsedDiesel 1.00
Page 290 of 466
Inspector Acknowledged Receipt: MOSTAFA MAHMUD
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Billing Address:
,
Notes:
Page 291 of 466
Inspector Acknowledged Receipt: MOSTAFA MAHMUD
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/19/2011 Business ID: 00500712 Inspection: AU001382Business: SAMS CLUB #4788 Store #: 4788
4571 S LABURNMUM Phone: 804-222-5208Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 3 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B23 47806B-2 Diesel 2 0 Approved 5.000WAYNE B23 47807B-7 Diesel 7 0 Approved 5.000WAYNE B12 47805B-12 87 12 0 Approved 5.000
Device Product Used: 15. Insp Product Used: . Tot Product Used: 15.Grade Prod Used87 5.00Diesel 10.00
Billing Address:
,
Notes:
Page 292 of 466
Inspector Acknowledged Receipt: REECE HUNSUCKER iii
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/19/2011 Business ID: 00112832 Inspection: AU001383Business: 60 MART Store #:
3109 WILLIAMSBURG RD Phone: (804)226-1059Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 13 9 4
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B70 PA104034-7 87 7 0 Not Tested 0.000GILBARCO B70 PA104034-7 89 7 0 Not Tested 0.000GILBARCO B70 PA104034-7 93 7 0 Not Tested 0.000GILBARCO B79 PA104014-3 89 3 0 Approved 0.000TOKHEIM 1150AT3 0241191430-11 Kerosene 11 0 Not Tested 0.000GILBARCO B79 PA104013-5 87 5 0 Approved 0.000GILBARCO B79 PA104013-5 89 5 0 Approved 0.000GILBARCO B79 PA104013-5 93 5 0 Approved 0.000GILBARCO B79 PA104013-6 87 6 0 Approved 5.000GILBARCO B79 PA104013-6 89 6 0 Approved 5.000GILBARCO B79 PA104013-6 93 6 0 Approved 5.000GILBARCO B79 PA104014-3 87 3 0 Approved 0.000GILBARCO B79 PA104014-4 89 4 0 Approved 0.000
Device Product Used: 15. Insp Product Used: . Tot Product Used: 15.Grade Prod Used87 5.0089 5.0093 5.00
Page 293 of 466
Inspector Acknowledged Receipt: SARAVANAN KRISHNARAJ
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Billing Address:
,
Notes:
NOT USING # 7 OR # 11 AT THIS TIME WERE NOT TESTED
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357
Page 294 of 466
Inspector Acknowledged Receipt: SARAVANAN KRISHNARAJ
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 295 of 466
Inspector Acknowledged Receipt: SARAVANAN KRISHNARAJ
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/19/2011 Business ID: 00111773 Inspection: AU001386Business: FRENDLY QUICK MART CITGO Store #:
1290 N LABURNUM AVE Phone: (804)788-1328Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 3 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B85 PA182203-4 87 4 0 Approved 5.000GILBARCO B85 PA182203-4 89 4 0 Approved 5.000GILBARCO B85 PA182203-4 93 4 0 Approved 5.000
Device Product Used: 15. Insp Product Used: . Tot Product Used: 15.Grade Prod Used87 5.0089 5.0093 5.00
Billing Address:
,
Notes:
Page 296 of 466
Inspector Acknowledged Receipt: JAHANGIR CHY
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/19/2011 Business ID: 00112911 Inspection: AU001387Business: STAPLES MILL SHELL Store #: #116954
6001 STAPLES MILL RD Phone: (804)264-1900Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
08/19/11 01:07 PM 01:31 PM 0:24 0:00 0:24 C-8986Total: 0:24 0:00 0:24
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 1/V58D4/GQY 724232-1 87 1 0 Condemned 0.000
Billing Address:
,
Notes:
meter creeping at end of sale
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 297 of 466
Inspector Acknowledged Receipt: KASSA ENANU
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 298 of 466
Inspector Acknowledged Receipt: KASSA ENANU
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/23/2011 Business ID: 00110848 Inspection: AU001389Business: HESS Store #: 46504
3801 MECHANICSVILLE TNPK Phone: 804-329-3921Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 15 15
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE V390D1/GQY 649708-3 87 3 0 Approved 5.000WAYNE V390D1/GQY 649708-4 87 4 0 Approved 0.000WAYNE V390D1/GQY 649708-4 89 4 -1 Approved 1.000WAYNE V390D1/GQY 649708-4 93 4 0 Approved 0.000WAYNE V390D1/GQY 714414-5 87 5 -1 Approved 1.000WAYNE V390D1/GQY 649710-8 87 8 0 Approved 0.000WAYNE V390D1/GQY 649707-10 87 10 0 Approved 0.000WAYNE V390D1/GQY 649707-10 89 10 0 Approved 0.000WAYNE V390D1/GQY 649707-10 93 10 0 Approved 0.000WAYNE V390D1/GQY 714415-11 87 11 0 Approved 0.000WAYNE V390D1/GQY 714415-11 89 11 0 Approved 0.000WAYNE V390D1/GQY 714415-11 93 11 0 Approved 0.000WAYNE V387D1/GQY 648496-14 Diesel 14 0 Approved 0.000WAYNE V387D1/GQY 648499-15 Kerosene 15 0 Approved 0.000WAYNE V387D1/GQY 648499-16 Kerosene 16 0 Approved 0.000
Device Product Used: 7. Insp Product Used: . Tot Product Used: 7.Grade Prod Used87 6.0089 1.00
Page 299 of 466
Inspector Acknowledged Receipt: NURUK KHALIFA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Billing Address:
,
Notes:
Page 300 of 466
Inspector Acknowledged Receipt: NURUK KHALIFA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/23/2011 Business ID: 00021685 Inspection: AU001390Business: LUCKYS Store #:
607 E LABURNUM AVE Phone: 804-329-9349Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23222 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 14 14Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B12/3223D1/JK 63006A-1 87 1 0 Approved 0.000WAYNE B12/3223D1/JK 63006A-1 89 1 0 Approved 0.000WAYNE B12/3223D1/JK 63006A-1 93 1 0 Approved 0.000WAYNE B12/3223D1/JK 63006A-2 87 2 0 Approved 0.000WAYNE B12/3223D1/JK 63006A-2 89 2 0 Approved 0.000WAYNE B12/3223D1/JK 63006A-2 93 2 0 Approved 0.000WAYNE B12/3223D1/JK 63008A-3 87 3 0 Approved 0.000WAYNE B12/3223D1/JK 63008A-3 89 3 0 Approved 0.000WAYNE B12/3223D1/JK 63008A-3 93 3 0 Approved 0.000WAYNE B12/3223D1/JK 63008A-4 93 4 0 Approved 0.000WAYNE B12/3223D1/JK 63005A-8 89 8 0 Approved 0.000WAYNE B12/3223D1/JK 63005A-8 93 8 0 Approved 0.000WAYNE R11-1220D1/J 63009A-9 Diesel 9 0 Approved 0.000WAYNE R11-1220D1/J 63009A-10 Diesel 10 0 Approved 0.000
Billing Address:
,
Page 301 of 466
Inspector Acknowledged Receipt: AHMED SOILEH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Notes:
Page 302 of 466
Inspector Acknowledged Receipt: AHMED SOILEH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/23/2011 Business ID: 00161991 Inspection: AU001391Business: QUICK TRIP Store #:
510 E LABURNUM AVE Phone: (804)321-7864Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 3 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 CTEN151866-1 87 1 -1 Approved 1.000GILBARCO NN1 CTEN151866-1 89 1 0 Approved 0.000GILBARCO NN1 CTEN151866-1 93 1 0 Approved 0.000
Device Product Used: 1. Insp Product Used: . Tot Product Used: 1.Grade Prod Used87 1.00
Billing Address:
,
Notes:
Page 303 of 466
Inspector Acknowledged Receipt: BALWINDER SINGH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/23/2011 Business ID: 00248860 Inspection: AU001392Business: WAWA Store #: #8603
8017 W BROAD STREET Phone: (804)290-4374Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23294 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 15 15
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 MPEN085115-3 87 3 0 Approved 5.000GILBARCO NN1 MPEN085115-3 89 3 0 Approved 5.000GILBARCO NN1 MPEN085115-3 93 3 0 Approved 0.000GILBARCO NN1 MPEN085115-4 87 4 0 Approved 0.000GILBARCO NN1 MPEN085115-4 89 4 0 Approved 0.000GILBARCO NN1 MPEN085115-4 93 4 0 Approved 0.000GILBARCO NN1 MPEN085120-5 87 5 0 Approved 0.000GILBARCO NN1 MPEN085120-5 89 5 0 Approved 0.000GILBARCO NN1 MPEN085120-5 93 5 0 Approved 0.000GILBARCO NN1 JPEN079066-7 87 7 0 Approved 5.000GILBARCO NN1 JPEN079066-7 89 7 0 Approved 5.000GILBARCO NN1 JPEN079066-7 93 7 0 Approved 5.000GILBARCO NN1 JPEN079066-8 87 8 0 Approved 5.000GILBARCO NN1 JPEN079066-8 89 8 0 Approved 5.000GILBARCO NN1 JPEN079066-8 93 8 0 Approved 5.000
Device Product Used: 40. Insp Product Used: . Tot Product Used: 40.Grade Prod Used87 15.0089 15.0093 10.00
Page 304 of 466
Inspector Acknowledged Receipt: SHANE MASON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Billing Address:
,
Notes:
Page 305 of 466
Inspector Acknowledged Receipt: SHANE MASON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/23/2011 Business ID: 00110560 Inspection: AU001393Business: PARHAM BP Store #:
9100 THREE CHOPT RD Phone: 804-270-4798Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Reinspection 2
Class Actv App Rej Con CwC NTLiquid Measuring Device 2 2
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H426B- PMR036426-9 87 9 0 Approved 5.000TOKHEIM H426B- PMR036426-10 93 10 0 Approved 5.000
Device Product Used: 10. Insp Product Used: . Tot Product Used: 10.Grade Prod Used87 5.0093 5.00
Billing Address:
,
Notes:
Page 306 of 466
Inspector Acknowledged Receipt: MANISH PATELHH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/23/2011 Business ID: 00163076 Inspection: AU001394Business: EXXON WEST END Store #: #28407
9525 W BROAD ST Phone: (804)615-5102Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 7 4 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO AK1220 CA013960-3 87 3 0 Approved 0.000GILBARCO AK1220 CA013960-3 89 3 0 Approved 0.000GILBARCO AK1220 CA013960-3 93 3 0 Approved 0.000GILBARCO AK1220 CA013960-4 93 4 0 Approved 5.000GILBARCO AK1220 CA014204-8 87 8 0 Condemned 0.000GILBARCO AK1220 CA014204-8 89 8 0 Condemned 0.000GILBARCO AK1220 CA014204-8 93 8 0 Condemned 0.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used93 5.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 307 of 466
Inspector Acknowledged Receipt: MANJINDER KAUR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 308 of 466
Inspector Acknowledged Receipt: MANJINDER KAUR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/26/2011 Business ID: 00161644 Inspection: AU001400Business: UPPYS# 27 Store #: #27
8601 PATTERSON AVE Phone: 804-864-5379Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
08/26/11 09:10 AM 09:35 AM 0:25 0:00 0:25 C-8990 NO PROBLEM WAS FOUNDTotal: 0:25 0:00 0:25
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B05 PA049483-6 87 6 0 Approved 0.000
Billing Address:
,
Notes:
Page 309 of 466
Inspector Acknowledged Receipt: BRIGITTE SCOTT
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 8/26/2011 Business ID: 00113723 Inspection: AU001402Business: ROY'S EXPRESS MART Store #:
7605 STAPLES MILL RD Phone: (804)266-0382Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 6 6
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE D359023gqy 608504-2 89 2 0 Approved 5.000WAYNE D359023gqy 608510-3 89 3 0 Approved 5.000WAYNE D359023gqy 608510-3 93 3 0 Approved 5.000WAYNE D359023gqy 608510-4 93 4 0 Approved 5.000WAYNE D359023gqy 608513-6 87 6 0 Approved 5.000WAYNE D359023gqy 608513-6 89 6 0 Approved 5.000
Device Product Used: 30. Insp Product Used: . Tot Product Used: 30.Grade Prod Used87 5.0089 15.0093 10.00
Billing Address:
,
Notes:
Page 310 of 466
Inspector Acknowledged Receipt: ZARINA MADHANI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 9/15/2011 Business ID: 00163076 Inspection: AU001430Business: EXXON WEST END Store #: #28407
9525 W BROAD ST Phone: (804)615-5102Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Reinspection 2
Class Actv App Rej Con CwC NTLiquid Measuring Device 3 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO AK1220 CA014204-8 87 8 0 Approved 0.000GILBARCO AK1220 CA014204-8 89 8 0 Approved 0.000GILBARCO AK1220 CA014204-8 93 8 0 Approved 0.000
Billing Address:
,
Notes:
Page 311 of 466
Inspector Acknowledged Receipt: JAG DEEP SINGH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 9/19/2011 Business ID: 00112831 Inspection: AU001433Business: BROOK EXPRESS MART Store #:
7101 BROOK RD Phone: 804-264-6986Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23227 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
09/19/11 02:10 PM 02:35 PM 0:25 0:00 0:25 C-9039 NO PROBLEM WAS FOUNDTotal: 0:25 0:00 0:25
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B78 PA083656-8 87 8 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 312 of 466
Inspector Acknowledged Receipt: ZAHEER MAZHAR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 9/23/2011 Business ID: 00111757 Inspection: AU001440Business: HENRICO CHUBBY'S Store #:
6016 W BROAD ST Phone: (804)285-4469Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23230 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
09/23/11 02:21 PM 02:42 PM 0:21 0:00 0:21 C-9055 NO PROBLEM FOUNDTotal: 0:21 0:00 0:21
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 DUEN164918-1 87 1 0 Approved 0.000
Billing Address:
,
Notes:
Page 313 of 466
Inspector Acknowledged Receipt: ALPESH PATEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 10/13/2011 Business ID: 00021927 Inspection: AU001458Business: HANDI STOP DELI Store #:
17-B HANOVER RD Phone: (804)737-8524Inspector: 325 MIKE TILLMAN
SANDSTON, VA 23150 Reason: Reinspection 2
Class Actv App Rej Con CwC NTLiquid Measuring Device 9 9
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B23 4223D1/JK-1 87 #1 0 Approved 0.000WAYNE B23 4223D1/JK-1 Diesel #1 0 Approved 0.000WAYNE B23 4223D1/JK-1 89 #1 0 Approved 0.000WAYNE B12 3223D1/JK-4 87 #4 0 Approved 0.000WAYNE B23 4223D1/JK-1 93 #1 0 Approved 0.000WAYNE B12 3223D1/JK-4 89 #4 0 Approved 0.000WAYNE B12 3223D1/JK-3 87 #3 0 Approved 0.000WAYNE B12 3223D1/JK-3 89 #3 0 Approved 0.000WAYNE B12 3223D1/JK-3 93 #3 0 Approved 0.000
Billing Address:
,
Notes:
Page 314 of 466
Inspector Acknowledged Receipt: D H SHAH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 10/13/2011 Business ID: 00021473 Inspection: AU001459Business: FAST STOP 1 Store #:
2301 MECHANICSVILLE TNPK Phone: (804)782-9326Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 10 10
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B05 PA037478-11 89 11 0 Approved 0.000GILBARCO B05 PA037483-5 Diesel 5 0 Approved 0.000GILBARCO B05 PAO37481-2 89 2 0 Approved 0.000GILBARCO B05 PA037482-4 87 4 0 Approved 0.000GILBARCO B05 PA037482-4 93 4 0 Approved 5.000GILBARCO B05 PA037479-8 87 8 0 Approved 0.000GILBARCO B05 PA037479-8 89 8 0 Approved 0.000GILBARCO B05 PA037480-10 87 10 -1 Approved 1.000GILBARCO B05 PA037478-11 87 11 0 Approved 0.000GILBARCO B05 PA037478-11 93 11 0 Approved 0.000
Device Product Used: 6. Insp Product Used: . Tot Product Used: 6.Grade Prod Used87 1.0093 5.00
Billing Address:
,
Page 315 of 466
Inspector Acknowledged Receipt: DAVID ALLISON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Notes:
Page 316 of 466
Inspector Acknowledged Receipt: DAVID ALLISON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 10/14/2011 Business ID: 00113700 Inspection: AU001461Business: FAS MART Store #: #52
4001 E WILLIAMSBURG RD Phone: (804)737-1300Inspector: 325 MIKE TILLMAN
SANDSTON, VA 23150 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
10/14/11 12:49 PM 01:17 PM 0:28 0:00 0:28 C-9092 NO PROBLEM FOUNDTotal: 0:28 0:00 0:28
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE X1/V590D4/GJ 713376-10 87 10 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 317 of 466
Inspector Acknowledged Receipt: PAM LESTER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 10/14/2011 Business ID: 00500704 Inspection: AU001462Business: VARAINA CONVENIENCE STORE INC. Store #:
3275 NEW MARKET RD Phone: 804-795-4213Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Reinspection 2
Class Actv App Rej Con CwC NTLiquid Measuring Device 3 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 EN-007437-15 89 15 0 Approved 5.000GILBARCO NN1 EN-007437-15 87 15 0 Approved 5.000GILBARCO NN1 EN-007437-15 93 15 0 Approved 5.000
Device Product Used: 15. Insp Product Used: . Tot Product Used: 15.Grade Prod Used87 5.0089 5.0093 5.00
Billing Address:
,
Notes:
Page 318 of 466
Inspector Acknowledged Receipt: SAMIRA SURANI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/1/2011 Business ID: 00113657 Inspection: AU001483Business: MEGA MART Store #:
1611 MOUNTAIN RD Phone: (804)553-1458Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Reinspection 2
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO RAC 1921 A 2412-11 Kerosene 11 0 Condemned 0.000
Billing Address:
,
Notes:
TOTAL GALLON AND PRICE PER GALLON NOT READABLE
MAY NEED TO REPLACE GLASS
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are
Page 319 of 466
Inspector Acknowledged Receipt: atif ali
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 320 of 466
Inspector Acknowledged Receipt: atif ali
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/2/2011 Business ID: 00161694 Inspection: AU001485Business: EXXON ALANS Store #: #28117
8800 QUIOCCASIN RD Phone: 804-740-8243Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 24 24Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 KXEN232972-A 87 1 0 Approved 5.000 GILBARCO NN1 KXEN232972-A 89 1 0 Approved 5.000 GILBARCO NN1 KXEN232972-A 93 1 0 Approved 5.000 GILBARCO NN1 KXEN232972--B 87 2 0 Approved 5.000 GILBARCO NN1 KXEN232972--B 89 2 0 Approved 5.000 GILBARCO NN1 KXEN232972--B 93 2 0 Approved 5.000 GILBARCO NN1 KXEN232973-A 87 3 0 Approved 5.000 GILBARCO NN1 KXEN232973-A 89 3 0 Approved 5.000 GILBARCO NN1 KXEN232973-A 93 3 0 Approved 5.000 GILBARCO NN1 KXEN232973-B 87 4 0 Approved 5.000 GILBARCO NN1 KXEN232973-B 89 4 0 Approved 5.000 GILBARCO NN1 KXEN232973-B 93 4 0 Approved 5.000 GILBARCO NN1 KXEN232974-A 87 5 0 Approved 5.000 GILBARCO NN1 KXEN232974-A 89 5 0 Approved 5.000 GILBARCO NN1 KXEN232974-A 93 5 0 Approved 5.000 GILBARCO NN1 KXEN232974-B 87 6 0 Approved 5.000 GILBARCO NN1 KXEN232974-B 89 6 0 Approved 5.000 GILBARCO NN1 KXEN232974-B 93 6 0 Approved 5.000 GILBARCO NN1 KXEN232975-A 87 7 0 Approved 5.000 GILBARCO NN1 KXEN232975-A 89 7 0 Approved 5.000
Page 321 of 466
Inspector Acknowledged Receipt: BHADRESH PATEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 KXEN232975-A 93 7 0 Approved 5.000 GILBARCO NN1 KXEN232975-B 87 8 0 Approved 5.000 GILBARCO NN1 KXEN232975-B 89 8 0 Approved 5.000 GILBARCO NN1 KXEN232975-B 93 8 0 Approved 5.000
Device Product Used: 120. Insp Product Used: . Tot Product Used: 120.Grade Prod Used87 40.0089 40.0093 40.00
Billing Address:
,
Notes:
Page 322 of 466
Inspector Acknowledged Receipt: BHADRESH PATEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/7/2011 Business ID: 00161972 Inspection: AU001492Business: CORNER MART Store #:
4050 SPRING OAK DR Phone: (804)364-4930Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 24 24Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 1/590D4/GQU 702303-7 87 7 0 Approved 5.000WAYNE 1/590D4/GQU 702305-1 87 1 0 Approved 5.000WAYNE 1/590D4/GQU 702305-1 89 1 0 Approved 5.000WAYNE 1/590D4/GQU 702305-1 93 1 0 Approved 5.000WAYNE 1/590D4/GQU 702305-2 87 2 0 Approved 5.000WAYNE 1/590D4/GQU 702305-2 89 2 0 Approved 5.000WAYNE 1/590D4/GQU 702305-2 93 2 0 Approved 5.000WAYNE 1/590D4/GQU 702304-3 87 3 0 Approved 5.000WAYNE 1/590D4/GQU 702304-3 89 3 0 Approved 5.000WAYNE 1/590D4/GQU 702304-3 93 3 0 Approved 5.000WAYNE 1/590D4/GQU 702304-4 87 4 0 Approved 5.000WAYNE 1/590D4/GQU 702304-4 89 4 0 Approved 5.000WAYNE 1/590D4/GQU 702304-4 93 4 0 Approved 5.000WAYNE 1/590D4/GQU 702306-5 87 5 0 Approved 5.000WAYNE 1/590D4/GQU 702306-5 89 5 0 Approved 5.000WAYNE 1/590D4/GQU 702306-5 93 5 0 Approved 5.000WAYNE 1/590D4/GQU 702306-6 87 6 0 Approved 5.000WAYNE 1/590D4/GQU 702306-6 89 6 0 Approved 5.000WAYNE 1/590D4/GQU 702306-6 93 6 0 Approved 5.000WAYNE 1/590D4/GQU 702303-7 89 7 0 Approved 5.000
Page 323 of 466
Inspector Acknowledged Receipt: VALENTINO RAHMAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 1/590D4/GQU 702303-7 93 7 0 Approved 5.000WAYNE 1/590D4/GQU 702303-8 87 8 0 Approved 5.000WAYNE 1/590D4/GQU 702303-8 89 8 0 Approved 5.000WAYNE 1/590D4/GQU 702303-8 93 8 0 Approved 5.000
Device Product Used: 120. Insp Product Used: . Tot Product Used: 120.Grade Prod Used87 40.0089 40.0093 40.00
Billing Address:
,
Notes:
Page 324 of 466
Inspector Acknowledged Receipt: VALENTINO RAHMAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/7/2011 Business ID: 00113715 Inspection: AU001493Business: WOODMAN FOOD MART Store #:
9024 WOODMAN RD Phone: (804)266-9241Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 13 13Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B65 PA024145-1 87 1 0 Approved 5.000GILBARCO B65 PA024145-1 89 1 0 Approved 5.000GILBARCO B65 PA024145-1 93 1 0 Approved 5.000GILBARCO B65 PA024145-2 89 2 0 Approved 5.000GILBARCO B65 PA024145-2 87 2 0 Approved 5.000GILBARCO B65 PA024145-2 93 2 0 Approved 5.000GILBARCO B65 PA024146-4 87 4 0 Approved 5.000GILBARCO B65 PA024146-4 89 4 0 Approved 5.000GILBARCO B65 PA024146-4 93 4 0 Approved 5.000GILBARCO B65 PA024146-5 87 5 0 Approved 5.000GILBARCO B65 PA024146-5 89 5 0 Approved 5.000GILBARCO B65 PA024146-5 93 5 0 Approved 5.000GILBARCO AC1921 00526-3 Kerosene 3 0 Approved 5.000
Device Product Used: 65. Insp Product Used: . Tot Product Used: 65.Grade Prod Used87 20.0089 20.0093 20.00Kerosene 5.00
Page 325 of 466
Inspector Acknowledged Receipt: SUNNY THOBANI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Billing Address:
,
Notes:
Page 326 of 466
Inspector Acknowledged Receipt: SUNNY THOBANI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/8/2011 Business ID: 00500753 Inspection: AU001494Business: HUNTON GENERAL STORE Store #:
11701 GREENWOOD RD Phone: 804-266-3205Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23059 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1Small Capacity Scale 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO AC5821 94161 87 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 327 of 466
Inspector Acknowledged Receipt: DALE MCCLURE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/8/2011 Business ID: 00113721 Inspection: AU001496Business: FAS MART Store #: #12
4690 POUNCY TRACT RD Phone: (804)364-2977Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 30 30Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE X1/V590D4/GJ 717233-9 93 9 0 Approved 5.000WAYNE X1/V590D4/GJ 717239-1 87 1 0 Approved 5.000WAYNE X1/V590D4/GJ 717239-1 89 1 0 Approved 5.000WAYNE X1/V590D4/GJ 717239-1 93 1 0 Approved 5.000WAYNE X1/V590D4/GJ 717239-2 87 2 0 Approved 5.000WAYNE X1/V590D4/GJ 717239-2 89 2 0 Approved 5.000WAYNE X1/V590D4/GJ 717239-2 93 2 0 Approved 5.000WAYNE X1/V590D4/GJ 717231-3 87 3 0 Approved 5.000WAYNE X1/V590D4/GJ 717231-3 89 3 0 Approved 5.000WAYNE X1/V590D4/GJ 717231-3 93 3 0 Approved 5.000WAYNE X1/V590D4/GJ 717231-4 87 4 0 Approved 5.000WAYNE X1/V590D4/GJ 717231-4 89 4 0 Approved 5.000WAYNE X1/V590D4/GJ 717231-4 93 4 0 Approved 5.000WAYNE X1/V590D4/GJ 717235-5 87 5 0 Approved 5.000WAYNE X1/V590D4/GJ 717235-5 89 5 0 Approved 5.000WAYNE X1/V590D4/GJ 717235-5 93 5 0 Approved 5.000WAYNE X1/V590D4/GJ 717235-6 87 6 0 Approved 5.000WAYNE X1/V590D4/GJ 717235-6 89 6 0 Approved 5.000WAYNE X1/V590D4/GJ 717235-6 93 6 0 Approved 5.000WAYNE X1/V590D4/GJ 717232-7 87 7 0 Approved 5.000
Page 328 of 466
Inspector Acknowledged Receipt: SHONITA WILLIAMS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE X1/V590D4/GJ 717232-7 89 7 0 Approved 5.000WAYNE X1/V590D4/GJ 717232-7 93 7 0 Approved 5.000WAYNE X1/V590D4/GJ 717232-8 87 8 0 Approved 5.000WAYNE X1/V590D4/GJ 717232-8 89 8 0 Approved 5.000WAYNE X1/V590D4/GJ 717232-8 93 8 0 Approved 5.000WAYNE X1/V590D4/GJ 717233-9 87 9 0 Approved 5.000WAYNE X1/V590D4/GJ 717233-9 89 9 0 Approved 5.000WAYNE X1/V590D4/GJ 717233-10 87 10 0 Approved 5.000WAYNE X1/V590D4/GJ 717233-10 89 10 0 Approved 5.000WAYNE X1/V590D4/GJ 717233-10 93 10 0 Approved 5.000
Device Product Used: 150. Insp Product Used: . Tot Product Used: 150.Grade Prod Used87 50.0089 50.0093 50.00
Billing Address:
,
Notes:
Page 329 of 466
Inspector Acknowledged Receipt: SHONITA WILLIAMS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/9/2011 Business ID: 00161994 Inspection: AU001498Business: MAC CHEVRON Store #:
1504 EAST RIDGE RD Phone: (804)658-4508Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229-5740 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 26 26Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B12/3223D6/LT 89733-A 87 1 0 Approved 5.000WAYNE B12/3223D6/LT 89733-A 89 1 0 Approved 5.000WAYNE B12/3223D6/LT 89733-A 93 1 0 Approved 5.000WAYNE B12/3223D6/LT 89733-B 87 2 0 Approved 5.000WAYNE B12/3223D6/LT 89733-B 89 2 0 Approved 5.000WAYNE B12/3223D6/LT 89733-B 93 2 0 Approved 5.000WAYNE B12/3223D6/LT 89731-A 87 3 0 Approved 5.000WAYNE B12/3223D6/LT 89731-A 89 3 0 Approved 5.000WAYNE B12/3223D6/LT 89731-A 93 3 0 Approved 5.000WAYNE B12/3223D6/LT 89731-B 87 4 0 Approved 5.000WAYNE B12/3223D6/LT 89731-B 89 4 0 Approved 5.000WAYNE B12/3223D6/LT 89731-B 93 4 0 Approved 5.000WAYNE B12/3223D6/LT 89732-A 87 5 0 Approved 5.000WAYNE B12/3223D6/LT 89732-A 89 5 0 Approved 5.000WAYNE B12/3223D6/LT 89732-A 93 5 0 Approved 5.000WAYNE B12/3223D6/LT 89732-B 87 6 0 Approved 5.000WAYNE B12/3223D6/LT 89732-B 89 6 0 Approved 5.000WAYNE B12/3223D6/LT 89732-B 93 6 0 Approved 5.000WAYNE B/23/4223D6/L 89734-A 87 7 0 Approved 5.000WAYNE B/23/4223D6/L 89734-A 89 7 0 Approved 5.000
Page 330 of 466
Inspector Acknowledged Receipt: PRITIPAL S MAC
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B/23/4223D6/L 89734-A 93 7 0 Approved 5.000WAYNE B/23/4223D6/L 89734-A Diesel 7 0 Approved 5.000WAYNE B/23/4223D6/L 89734-B 87 8 0 Approved 5.000WAYNE B/23/4223D6/L 89734-B 89 8 0 Approved 5.000WAYNE B/23/4223D6/L 89734-B 93 8 0 Approved 5.000WAYNE B/23/4223D6/L 89734-B Diesel 8 0 Approved 5.000
Device Product Used: 130. Insp Product Used: . Tot Product Used: 130.Grade Prod Used87 40.0089 40.0093 40.00Diesel 10.00
Billing Address:
,
Notes:
Page 331 of 466
Inspector Acknowledged Receipt: PRITIPAL S MAC
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/9/2011 Business ID: 00022322 Inspection: AU001499Business: WEST END MART TEXACO SERVICE Store #:
509 FOREST AVE Phone: (804)288-4862Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 12 12Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 4/590opc/u/o/v 77553-A 87 1 0 Approved 5.000WAYNE 4/590opc/u/o/v 77553-A 89 1 0 Approved 5.000WAYNE 4/590opc/u/o/v 77553-A 93 1 0 Approved 5.000WAYNE 4/590opc/u/o/v 77553-B 87 2 0 Approved 5.000WAYNE 4/590opc/u/o/v 77553-B 89 2 0 Approved 5.000WAYNE 4/590opc/u/o/v 77553-B 93 2 0 Approved 5.000WAYNE 4/590opc/u/o/v 77554-A 87 3 0 Approved 5.000WAYNE 4/590opc/u/o/v 77554-A 89 3 0 Approved 5.000WAYNE 4/590opc/u/o/v 77554-A 93 3 0 Approved 5.000WAYNE 4/590opc/u/o/v 77554-B 87 4 0 Approved 5.000WAYNE 4/590opc/u/o/v 77554-B 89 4 0 Approved 5.000WAYNE 4/590opc/u/o/v 77554-B 93 4 0 Approved 5.000
Device Product Used: 60. Insp Product Used: . Tot Product Used: 60.Grade Prod Used87 20.0089 20.0093 20.00
Page 332 of 466
Inspector Acknowledged Receipt: ED AHMED
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Billing Address:
,
Notes:
Page 333 of 466
Inspector Acknowledged Receipt: ED AHMED
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/10/2011 Business ID: 00110850 Inspection: AU001501Business: HESS Store #: #46505
7700 W BROAD ST Phone: 804-755-1291Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23294 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 35 35Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NJO CSEN122212-1 87 1 0 Approved 5.000GILBARCO NJO CSEN122212-1 89 1 0 Approved 5.000GILBARCO NJO CSEN122212-1 93 1 0 Approved 5.000GILBARCO NJO CSEN122212-2 87 2 0 Approved 5.000GILBARCO NJO CSEN122212-2 89 2 0 Approved 5.000GILBARCO NJO CSEN122212-2 93 2 0 Approved 5.000GILBARCO NJO CSEN122210-3 87 3 0 Approved 5.000GILBARCO NJO CSEN122210-3 89 3 0 Approved 5.000GILBARCO NJO CSEN122210-3 93 3 0 Approved 5.000GILBARCO NJO CSEN122210-4 87 4 0 Approved 5.000GILBARCO NJO CSEN122210-4 89 4 0 Approved 5.000GILBARCO NJO CSEN122210-4 93 4 0 Approved 5.000GILBARCO NJO CSEN123244-5 87 5 0 Approved 5.000GILBARCO NJO CSEN123244-5 89 5 0 Approved 5.000GILBARCO NJO CSEN123244-5 93 5 0 Approved 5.000GILBARCO NJO CSEN122211-6 87 6 0 Approved 5.000GILBARCO NJO CSEN122211-6 89 6 0 Approved 5.000GILBARCO NJO CSEN122211-6 93 6 0 Approved 5.000GILBARCO NJO CSEN122211-7 87 7 0 Approved 5.000GILBARCO NJO CSEN122211-7 89 7 0 Approved 5.000
Page 334 of 466
Inspector Acknowledged Receipt: dEBRA gALLA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NJO CSEN122211-7 93 7 0 Approved 5.000GILBARCO NJO CSEN122060-8 87 8 0 Approved 5.000GILBARCO NJO CSEN122060-8 89 8 0 Approved 5.000GILBARCO NJO CSEN122060-8 93 8 0 Approved 5.000GILBARCO NJO CSEN122060-9 87 9 0 Approved 5.000GILBARCO NJO CSEN122060-9 89 9 0 Approved 5.000GILBARCO NJO CSEN122060-9 93 9 0 Approved 5.000GILBARCO NJO CSEN122059-10 87 10 0 Approved 5.000GILBARCO NJO CSEN122059-10 89 10 0 Approved 5.000GILBARCO NJO CSEN122059-10 93 10 0 Approved 5.000GILBARCO NJO CSEN122059-11 87 11 0 Approved 5.000GILBARCO NJO CSEN122059-11 89 11 0 Approved 5.000GILBARCO NJO CSEN122059-11 93 11 0 Approved 5.000GILBARCO NAO CSEN122070-12 Kerosene 12 0 Approved 5.000GILBARCO NAO CSEN122070-13 Kerosene 13 0 Approved 5.000
Device Product Used: 175. Insp Product Used: . Tot Product Used: 175.Grade Prod Used87 55.0089 55.0093 55.00Kerosene 10.00
Billing Address:
,
Notes:
Page 335 of 466
Inspector Acknowledged Receipt: dEBRA gALLA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/10/2011 Business ID: 00112911 Inspection: AU001502Business: STAPLES MILL SHELL Store #: #116954
6001 STAPLES MILL RD Phone: (804)264-1900Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 1/V58D4/GQY 724232-1 87 1 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 336 of 466
Inspector Acknowledged Receipt: ENANU KASSABB
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/14/2011 Business ID: 00021386 Inspection: AU001504Business: REGENCY SHELL /SMO Store #:
1501 N PARHAM RD Phone: (804)282-4470Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 26 24 2Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B85 PA211616-1 87 1 0 Approved 5.000GILBARCO B87 PA211618-3 Diesel 3 18 Rejected 5.000GILBARCO B87 PA211618-4 87 4 0 Approved 5.000GILBARCO B85 PA211616-1 89 1 0 Approved 5.000GILBARCO B87 PA211618-4 Diesel 4 18 Rejected 5.000GILBARCO B85 PA211616-1 93 1 0 Approved 5.000GILBARCO B85 PA211616-2 87 2 0 Approved 5.000GILBARCO B85 PA211616-2 89 2 0 Approved 5.000GILBARCO B85 PA211616-2 93 2 0 Approved 5.000GILBARCO B85 PA211617-5 87 5 0 Approved 5.000GILBARCO B85 PA211617-5 89 5 0 Approved 5.000GILBARCO B85 PA211617-5 93 5 0 Approved 5.000GILBARCO B85 PA211617-6 87 6 0 Approved 5.000GILBARCO B85 PA211617-6 89 6 0 Approved 5.000GILBARCO B85 PA211617-6 93 6 0 Approved 5.000GILBARCO B85 PA211615-7 87 7 0 Approved 5.000GILBARCO B85 PA211615-7 89 7 0 Approved 5.000GILBARCO B85 PA211615-7 93 7 0 Approved 5.000GILBARCO B85 PA211615-8 87 8 0 Approved 5.000GILBARCO B85 PA211615-8 89 8 0 Approved 5.000
Page 337 of 466
Inspector Acknowledged Receipt: ERFAN KAYBBB
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B85 PA211615-8 93 8 0 Approved 5.000GILBARCO B87 PA211618-3 87 3 0 Approved 5.000GILBARCO B87 PA211618-3 89 3 0 Approved 5.000GILBARCO B87 PA211618-3 93 3 0 Approved 5.000GILBARCO B87 PA211618-4 89 4 0 Approved 5.000GILBARCO B87 PA211618-4 93 4 0 Approved 5.000
Device Product Used: 130. Insp Product Used: . Tot Product Used: 130.Grade Prod Used87 40.0089 40.0093 40.00Diesel 10.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled
Page 338 of 466
Inspector Acknowledged Receipt: ERFAN KAYBBB
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
"Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 339 of 466
Inspector Acknowledged Receipt: ERFAN KAYBBB
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/14/2011 Business ID: 00021415 Inspection: AU001505Business: QUIOCCASIN BP Store #:
9230 QUIOCCASIN RD Phone: 804--740-5683Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 24 24Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 JWEN207386-A 87 1 0 Approved 5.000 GILBARCO NN1 JWEN207386-A 89 1 0 Approved 5.000 GILBARCO NN1 JWEN207386-A 93 1 0 Approved 5.000 GILBARCO NN1 JWEN207386-B 87 2 0 Approved 5.000 GILBARCO NN1 JWEN207386-B 89 2 0 Approved 5.000 GILBARCO NN1 JWEN207386-B 93 2 0 Approved 5.000 GILBARCO NN1 DSEN125154-A 87 3 0 Approved 5.000 GILBARCO NN1 DSEN125154-A 89 3 0 Approved 5.000 GILBARCO NN1 DSEN125154-A 93 3 0 Approved 5.000 GILBARCO NN1 DSEN125154-B 87 4 0 Approved 5.000 GILBARCO NN1 DSEN125154-B 89 4 0 Approved 5.000 GILBARCO NN1 DSEN125154-B 93 4 0 Approved 5.000 GILBARCO NN1 DSEN125153-A 87 7 0 Approved 5.000 GILBARCO NN1 DSEN125153-A 89 7 0 Approved 5.000 GILBARCO NN1 DSEN125153-A 93 7 0 Approved 5.000 GILBARCO NN1 DSEN125153-B 87 8 0 Approved 5.000 GILBARCO NN1 DSEN125153-B 89 8 0 Approved 5.000 GILBARCO NN1 DSEN125153-B 93 8 0 Approved 5.000GILBARCO B79 PAO83412-A 87 5 0 Approved 5.000GILBARCO B79 PAO83412-A 89 5 0 Approved 5.000
Page 340 of 466
Inspector Acknowledged Receipt: AMIT PATEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PAO83412-A 93 5 0 Approved 5.000GILBARCO B79 PAO83412-B 87 6 0 Approved 5.000GILBARCO B79 PAO83412-B 89 6 0 Approved 5.000GILBARCO B79 PAO83412-B 93 6 0 Approved 5.000
Device Product Used: 120. Insp Product Used: . Tot Product Used: 120.Grade Prod Used87 40.0089 40.0093 40.00
Billing Address:
,
Notes:
Page 341 of 466
Inspector Acknowledged Receipt: AMIT PATEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/18/2011 Business ID: 00110848 Inspection: AU001510Business: HESS Store #: 46504
3801 MECHANICSVILLE TNPK Phone: 804-329-3921Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
11/18/11 03:06 PM 03:31 PM 0:25 0:00 0:25 C-9167 NO PROBLEM FOUNDTotal: 0:25 0:00 0:25
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE V387D1/GQY 648499-16 Kerosene 16 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod UsedKerosene 5.00
Billing Address:
,
Notes:
Page 342 of 466
Inspector Acknowledged Receipt: IF BRANDENBURG
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/28/2011 Business ID: 00163441 Inspection: AU001511Business: J P MARKET Store #:
6103 E NINE MILE RD Phone: (804)737-3118Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 24 12 12Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B12/3223D1/JK 99402A-1 87 1 0 Approved 5.000WAYNE B12/3223D1/JK 99402A-1 89 1 0 Approved 5.000WAYNE B12/3223D1/JK 99402A-1 93 1 0 Approved 5.000WAYNE B12/3223D1/JK 99402A-2 87 2 0 Approved 5.000WAYNE B12/3223D1/JK 99402A-2 89 2 0 Approved 5.000WAYNE B12/3223D1/JK 99402A-2 93 2 0 Approved 5.000WAYNE B12/3223D1/JK 99403A-3 87 3 0 Condemned 5.000WAYNE B12/3223D1/JK 99403A-3 89 3 0 Condemned 5.000WAYNE B12/3223D1/JK 99403A-3 93 3 0 Condemned 5.000WAYNE B12/3223D1/JK 99403A-4 87 4 0 Approved 5.000WAYNE B12/3223D1/JK 99403A-4 89 4 0 Approved 5.000WAYNE B12/3223D1/JK 99403A-4 93 4 0 Approved 5.000WAYNE B12/3223D1/JK 99404A-5 87 5 0 Approved 5.000WAYNE B12/3223D1/JK 99404A-5 89 5 0 Approved 5.000WAYNE B12/3223D1/JK 99404A-5 93 5 0 Approved 5.000WAYNE B12/3223D1/JK 99404A-6 87 6 0 Condemned 5.000WAYNE B12/3223D1/JK 99404A-6 89 6 0 Condemned 5.000WAYNE B12/3223D1/JK 99404A-6 93 6 0 Condemned 5.000WAYNE B12/3223D1/JK 99405A-7 87 7 0 Condemned 5.000WAYNE B12/3223D1/JK 99405A-7 89 7 0 Condemned 5.000
Page 343 of 466
Inspector Acknowledged Receipt: SATINDER SINGH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B12/3223D1/JK 99405A-7 93 7 0 Condemned 5.000WAYNE B12/3223D1/JK 99405A-8 87 8 0 Condemned 5.000WAYNE B12/3223D1/JK 99405A-8 89 8 0 Condemned 5.000WAYNE B12/3223D1/JK 99405A-8 93 8 0 Condemned 5.000
Device Product Used: 120. Insp Product Used: . Tot Product Used: 120.Grade Prod Used87 40.0089 40.0093 40.00
Billing Address:
,
Notes:
PUMP # 7,8,6 &,3 ANTI DRAIN MEANS NOT WORKING.
PUMP # 3 87 MISSING PRICE PER GALLON.
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled
Page 344 of 466
Inspector Acknowledged Receipt: SATINDER SINGH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
"Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 345 of 466
Inspector Acknowledged Receipt: SATINDER SINGH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/28/2011 Business ID: 00163374 Inspection: AU001512Business: POINTERS FOOD MART Store #:
400 W NINE MILE RD Phone: (804)328-1855Inspector: 325 MIKE TILLMAN
HIGHLAND SPRINGS, VA 23075 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 14 14Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 590D1/GQUY 681080-1 87 1 0 Approved 5.000WAYNE 590D1/GQUY 681080-3 87 3 0 Approved 5.000WAYNE 590D1/GQUY 681080-1 89 1 0 Approved 5.000WAYNE 590D1/GQUY 681080-1 93 1 0 Approved 5.000WAYNE 590D1/GQUY 681082-2 87 2 0 Approved 5.000WAYNE 590D1/GQUY 681080-3 89 3 0 Approved 5.000WAYNE 590D1/GQUY 681080-3 93 3 0 Approved 5.000WAYNE 590D1/GQUY 681082-2 89 2 0 Approved 5.000WAYNE 590D1/GQUY 681082-2 93 2 0 Approved 5.000WAYNE 590D1/GQUY 681082-4 87 4 0 Approved 5.000WAYNE 590D1/GQUY 681082-4 89 4 0 Approved 5.000WAYNE 590D1/GQUY 681082-4 93 4 0 Approved 5.000WAYNE D13382 506598-5 Kerosene 5 0 Approved 5.000WAYNE DL531 505771-6 Diesel 6 0 Approved 5.000
Device Product Used: 70. Insp Product Used: . Tot Product Used: 70.Grade Prod Used87 20.0089 20.0093 20.00
Page 346 of 466
Inspector Acknowledged Receipt: ELLEN PIERCE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Diesel 5.00Kerosene 5.00
Billing Address:
,
Notes:
Page 347 of 466
Inspector Acknowledged Receipt: ELLEN PIERCE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 11/29/2011 Business ID: 00163583 Inspection: AU001515Business: NORTH PARK SHELL Store #: #10
805 PARHAM RD Phone: 804-266-4407Inspector: 325 MIKE TILLMAN
RICHM0ND, VA 23227 Reason: Reinspection 2
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B78 PA141848-12 87 12 0 Approved 1.000
Device Product Used: 1. Insp Product Used: . Tot Product Used: 1.Grade Prod Used87 1.00
Billing Address:
,
Notes:
Page 348 of 466
Inspector Acknowledged Receipt: ASAAD MUNIR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/2/2011 Business ID: 00021214 Inspection: AU001518Business: VIRGINIA CENTER SHELL Store #:
9999 BROOK RD Phone: (804)281-0800Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23059 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 26 23 3Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 DPEN069203-1 87 1 0 Approved 5.000GILBARCO NN1 DPEN069203-1 89 1 0 Approved 5.000GILBARCO NN1 DPEN069203-1 93 1 0 Approved 5.000GILBARCO NN1 DPEN069203-2 87 2 0 Approved 5.000GILBARCO NN1 DPEN069203-2 89 2 0 Approved 5.000GILBARCO NN1 DPEN069203-2 93 2 0 Approved 5.000GILBARCO NN1 DPEN069202-3 87 3 0 Approved 5.000GILBARCO NN1 DPEN069202-3 89 3 0 Approved 5.000GILBARCO NN1 DPEN069202-3 93 3 0 Approved 5.000GILBARCO NN1 DPEN069202-4 87 4 0 Rejected 5.000GILBARCO NN1 DPEN069202-4 89 4 0 Rejected 5.000GILBARCO NN1 DPEN069202-4 93 4 0 Rejected 5.000GILBARCO NN1 DPEN069204-7 87 7 0 Approved 5.000GILBARCO NN1 DPEN069204-7 89 7 0 Approved 5.000GILBARCO NN1 DPEN069204-7 93 7 0 Approved 5.000GILBARCO NN1 DPEN069204-8 87 8 0 Approved 5.000GILBARCO NN1 DPEN069204-8 89 8 0 Approved 5.000GILBARCO NN1 DPEN069204-8 93 8 0 Approved 5.000GILBARCO NL1 DPEN069208-5 87 5 0 Approved 5.000GILBARCO NL1 DPEN069208-5 89 5 0 Approved 5.000
Page 349 of 466
Inspector Acknowledged Receipt: MIKE WELLS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NL1 DPEN069208-5 93 5 0 Approved 5.000GILBARCO NL1 DPEN069208-5 Diesel 5 0 Approved 5.000GILBARCO NL1 DPEN069208-6 87 6 0 Approved 5.000GILBARCO NL1 DPEN069208-6 89 6 0 Approved 5.000GILBARCO NL1 DPEN069208-6 93 6 0 Approved 5.000GILBARCO NL1 DPEN069208-6 Diesel 6 0 Approved 5.000
Device Product Used: 130. Insp Product Used: . Tot Product Used: 130.Grade Prod Used87 40.0089 40.0093 40.00Diesel 10.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled
Page 350 of 466
Inspector Acknowledged Receipt: MIKE WELLS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
"Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 351 of 466
Inspector Acknowledged Receipt: MIKE WELLS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/2/2011 Business ID: 00111215 Inspection: AU001519Business: LAKESIDE CITGO Store #: #36
5301 LAKESIDE AVE Phone: 804-262-2181Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 19 1 18Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE V580D1/GOY 651468-1 87 1 0 Rejected 5.000WAYNE V580D1/GOY 651468-2 87 2 0 Rejected 5.000WAYNE V580D1/GOY 651468-1 89 1 0 Rejected 5.000WAYNE V580D1/GOY 651468-1 93 1 0 Rejected 5.000WAYNE V580D1/GOY 651468-2 89 2 0 Rejected 5.000WAYNE V580D1/GOY 651468-2 93 2 0 Rejected 5.000WAYNE V580D1/GOY 651467-3 87 3 0 Rejected 5.000WAYNE V580D1/GOY 651467-3 89 3 0 Rejected 5.000WAYNE V580D1/GOY 651467-3 93 3 0 Rejected 5.000WAYNE V580D1/GOY 651467-4 87 4 0 Rejected 5.000WAYNE V580D1/GOY 651467-4 89 4 0 Rejected 5.000WAYNE V580D1/GOY 651467-4 93 4 0 Rejected 5.000WAYNE V580D1/GOY 650918-5 87 5 0 Rejected 5.000WAYNE V580D1/GOY 650918-5 89 5 0 Rejected 5.000WAYNE V580D1/GOY 650918-5 93 5 0 Rejected 5.000WAYNE V580D1/GOY 650918-6 87 6 0 Rejected 5.000WAYNE V580D1/GOY 650918-6 89 6 0 Rejected 5.000WAYNE V580D1/GOY 650918-6 93 6 0 Rejected 5.000WAYNE D1L/3611/196 652375-7 Kerosene 7 0 Approved 5.000
Page 352 of 466
Inspector Acknowledged Receipt: VIJAY SHAH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Device Product Used: 95. Insp Product Used: . Tot Product Used: 95.Grade Prod Used87 30.0089 30.0093 30.00Kerosene 5.00
Billing Address:
,
Notes:
ALL DISPENSERS MISSING 10% ETHANOL LABEL
# 2 & 6 ALSO MISSING PRICE PER GALLON ON 89 GRADE
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Page 353 of 466
Inspector Acknowledged Receipt: VIJAY SHAH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 354 of 466
Inspector Acknowledged Receipt: VIJAY SHAH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/6/2011 Business ID: 00112911 Inspection: AU001520Business: STAPLES MILL SHELL Store #: #116954
6001 STAPLES MILL RD Phone: (804)264-1900Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
12/06/11 08:48 AM 09:11 AM 0:23 0:00 0:23 C-9196 NO PROBLEM FOUNDTotal: 0:23 0:00 0:23
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 2/595D4 722340-4 87 4 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
Page 355 of 466
Inspector Acknowledged Receipt: ENANU KASSA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/6/2011 Business ID: 00161651 Inspection: AU001521Business: UPPYS CONVENIENCE Store #: #46
7020 STAPLES MILL RD Phone: (804)658-0725Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 38 38Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 MTEN160714-A 87 1 0 Approved 5.000GILBARCO NN1 MTEN160714-A 89 1 0 Approved 5.000GILBARCO NN1 MTEN160714-A 93 1 0 Approved 5.000GILBARCO NN1 MTEN160714-B 87 2 0 Approved 5.000GILBARCO NN1 MTEN160714-B 89 2 0 Approved 5.000GILBARCO NN1 MTEN160714-B 93 2 0 Approved 5.000GILBARCO NN1 MTEN160711-A 87 3 0 Approved 5.000GILBARCO NN1 MTEN160711-A 89 3 0 Approved 5.000GILBARCO NN1 MTEN160711-A 93 3 0 Approved 5.000GILBARCO NN1 MTEN160711-B 87 4 0 Approved 5.000GILBARCO NN1 MTEN160711-B 89 4 0 Approved 5.000GILBARCO NN1 MTEN160711-B 93 4 0 Approved 5.000GILBARCO NN1 MTEN160712-A 87 5 0 Approved 5.000GILBARCO NN1 MTEN160712-A 89 5 0 Approved 5.000GILBARCO NN1 MTEN160712-A 93 5 0 Approved 5.000GILBARCO NN1 MTEN160712-B 87 6 0 Approved 5.000GILBARCO NN1 MTEN160712-B 89 6 0 Approved 5.000GILBARCO NN1 MTEN160712-B 93 6 0 Approved 5.000GILBARCO NN1 MTEN160710-A 87 7 0 Approved 5.000GILBARCO NN1 MTEN160710-A 89 7 0 Approved 5.000
Page 356 of 466
Inspector Acknowledged Receipt: DANA FOREMAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 MTEN160710-A 93 7 0 Approved 5.000GILBARCO NN1 MTEN160710-B 87 8 0 Approved 5.000GILBARCO NN1 MTEN160710-B 89 8 0 Approved 5.000GILBARCO NN1 MTEN160710-B 93 8 0 Approved 5.000GILBARCO NN1 MTEN160713-A 87 11 0 Approved 5.000GILBARCO NN1 MTEN160713-A 89 11 0 Approved 5.000GILBARCO NN1 MTEN160713-A 93 11 0 Approved 5.000GILBARCO NN1 MTEN160713-B 87 12 0 Approved 5.000GILBARCO NN1 MTEN160713-B 89 12 0 Approved 5.000GILBARCO NN1 MTEN160713-B 93 12 0 Approved 5.000 GILBARCO NL1 MTEN160715-A 87 9 0 Approved 5.000 GILBARCO NL1 MTEN160715-A 89 9 0 Approved 5.000 GILBARCO NL1 MTEN160715-A 93 9 0 Approved 5.000 GILBARCO NL1 MTEN160715-A Diesel 9 0 Approved 5.000 GILBARCO NL1 MTEN160715-B 87 10 0 Approved 5.000 GILBARCO NL1 MTEN160715-B 89 10 0 Approved 5.000 GILBARCO NL1 MTEN160715-B 93 10 0 Approved 5.000 GILBARCO NL1 MTEN160715-B Diesel 10 0 Approved 5.000
Device Product Used: 190. Insp Product Used: . Tot Product Used: 190.Grade Prod Used87 60.0089 60.0093 60.00Diesel 10.00
Billing Address:
,
Notes:
Page 357 of 466
Inspector Acknowledged Receipt: DANA FOREMAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/8/2011 Business ID: 00113657 Inspection: AU001524Business: MEGA MART Store #:
1611 MOUNTAIN RD Phone: (804)553-1458Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Reinspection 3
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO RAC 1921 A 2412-11 Kerosene 11 0 Approved 0.000
Billing Address:
,
Notes:
Page 358 of 466
Inspector Acknowledged Receipt: ATIF ALI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/12/2011 Business ID: 00162015 Inspection: AU001528Business: E & C SHELL CORNER MART Store #: #14
2707 WILLIAMSBURG RD Phone: (804)222-4486Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231-2032 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 25 20 2 3Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NG0 EN020452-1 87 1 3 Approved 5.000GILBARCO NG0 EN020452-1 89 1 3 Approved 5.000GILBARCO NG0 EN020452-1 93 1 3 Approved 5.000GILBARCO NG0 EN020452-2 87 2 3 Approved 5.000GILBARCO NG0 EN020452-2 89 2 3 Approved 5.000GILBARCO NG0 EN020452-2 93 2 5 Approved 5.000GILBARCO NG0 EN020454-3 87 3 -2 Approved 5.000GILBARCO NG0 EN020454-3 89 3 -2 Approved 5.000GILBARCO NG0 EN020454-3 93 3 -3 Approved 5.000GILBARCO NG0 EN020454-4 87 4 -5 Approved 5.000GILBARCO NG0 EN020454-4 89 4 -2 Approved 5.000GILBARCO NG0 EN020454-4 93 4 0 Approved 5.000GILBARCO NG0 EN020455-5 87 5 -5 Approved 5.000GILBARCO NG0 EN020455-5 89 5 -3 Approved 5.000GILBARCO NG0 EN020455-5 93 5 -8 Rejected 5.000GILBARCO NG0 EN020455-6 87 6 -6 Approved 5.000GILBARCO NG0 EN020455-6 89 6 -3 Approved 5.000GILBARCO NG0 EN020455-6 93 6 -9 Rejected 5.000GILBARCO NG0 EN020453-7 87 7 0 Approved 5.000GILBARCO NG0 EN020453-7 89 7 0 Approved 5.000
Page 359 of 466
Inspector Acknowledged Receipt: TERRI ECKERT
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NG0 EN020453-7 93 7 0 Approved 5.000GILBARCO NG0 EN020453-8 87 8 2 Condemned 5.000GILBARCO NG0 EN020453-8 89 8 0 Condemned 5.000GILBARCO NG0 EN020453-8 93 8 0 Condemned 5.000GILBARCO AC4821A 274991-9 Kerosene 9 0 Approved 5.000
Device Product Used: 125. Insp Product Used: . Tot Product Used: 125.Grade Prod Used87 40.0089 40.0093 40.00Kerosene 5.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or
Page 360 of 466
Inspector Acknowledged Receipt: TERRI ECKERT
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 361 of 466
Inspector Acknowledged Receipt: TERRI ECKERT
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/13/2011 Business ID: 00111207 Inspection: AU001529Business: EAST COAST Store #: #59
9800 W BROAD ST Phone: (804)370-8110Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 39 37 2Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H 426B 071TCS61613-1 87 1 0 Approved 5.000TOKHEIM H322B-IV-RIT2 77PMP042116-14 Diesel 14 0 Approved 5.000TOKHEIM H 426B 071TCS61613-1 89 1 0 Approved 5.000TOKHEIM H 426B 071TCS61613-1 93 1 0 Approved 5.000TOKHEIM H 426B 071TCS61613-2 87 2 0 Approved 5.000TOKHEIM H 426B 071TCS61613-2 89 2 0 Approved 5.000TOKHEIM H 426B 071TCS61613-2 93 2 0 Approved 10.000TOKHEIM H 426B 071TCS61611-3 87 3 0 Approved 5.000TOKHEIM H 426B 071TCS61611-3 89 3 0 Approved 5.000TOKHEIM H 426B 071TCS61611-3 93 3 0 Approved 5.000TOKHEIM H 426B 071TCS61611-4 87 4 0 Approved 5.000TOKHEIM H 426B 071TCS61611-4 89 4 0 Approved 5.000TOKHEIM H 426B 071TCS61611-4 93 4 0 Approved 5.000TOKHEIM H 426B 071TCS61648-5 87 5 0 Approved 5.000TOKHEIM H 426B 071TCS61648-5 89 5 0 Approved 5.000TOKHEIM H 426B 071TCS61648-5 93 5 0 Approved 5.000TOKHEIM H 426B 071TCS61648-6 87 6 20 Condemned 10.000TOKHEIM H 426B 071TCS61648-6 89 6 0 Approved 5.000TOKHEIM H 426B 071TCS61648-6 93 6 0 Condemned 5.000TOKHEIM H 426B 071TCS61614-7 87 7 0 Approved 5.000
Page 362 of 466
Inspector Acknowledged Receipt: CHARLIE ROBINS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H 426B 071TCS61614-7 89 7 0 Approved 5.000TOKHEIM H 426B 071TCS61614-7 93 7 0 Approved 5.000TOKHEIM H 426B 071TCS61614-8 87 8 0 Approved 5.000TOKHEIM H 426B 071TCS61614-8 89 8 0 Approved 5.000TOKHEIM H 426B 071TCS61614-8 93 8 0 Approved 5.000TOKHEIM H 426B 071TCS61612-9 87 9 0 Approved 5.000TOKHEIM H 426B 071TCS61612-9 89 9 0 Approved 5.000TOKHEIM H 426B 071TCS61612-9 93 9 0 Approved 5.000TOKHEIM H 426B 071TCS61612-10 87 10 0 Approved 5.000TOKHEIM H 426B 071TCS61612-10 89 10 0 Approved 5.000TOKHEIM H 426B 071TCS61610-11 87 11 0 Approved 5.000TOKHEIM H 426B 071TCS61610-11 89 11 0 Approved 5.000TOKHEIM H 426B 071TCS61610-11 93 11 0 Approved 5.000TOKHEIM H 426B 071TCS61610-12 87 12 0 Approved 5.000TOKHEIM H 426B 071TCS61610-12 89 12 0 Approved 5.000TOKHEIM H 426B 071TCS61610-12 93 12 0 Approved 5.000TOKHEIM H322B-IV-RIT2 77PMP042116-13 Diesel 13 0 Approved 5.000TOKHEIM 262RC 049262019588-15 Kerosene 15 0 Approved 5.000TOKHEIM H 426B 071TCS61612-10 93 10 0 Approved 5.000
Device Product Used: 205. Insp Product Used: . Tot Product Used: 205.Grade Prod Used87 65.0089 60.0093 65.00Diesel 10.00Kerosene 5.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 363 of 466
Inspector Acknowledged Receipt: CHARLIE ROBINS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 364 of 466
Inspector Acknowledged Receipt: CHARLIE ROBINS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/13/2011 Business ID: 00238899 Inspection: AU001530Business: INNSBROOK EXXON Store #:
4101 DOMINION BLVD Phone: 804-290-4449Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 38 38Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 FMEN032051-8 93 8 0 Approved 5.000GILBARCO NN1 FMEN032052-3 87 3 0 Approved 5.000GILBARCO NN1 FMEN032052-3 89 3 0 Approved 5.000GILBARCO NN1 FMEN032052-3 93 3 0 Approved 5.000GILBARCO NN1 FMEN032052-4 87 4 0 Approved 5.000GILBARCO NN1 FMEN032052-4 89 4 0 Approved 5.000GILBARCO NN1 FMEN032052-4 93 4 0 Approved 5.000GILBARCO NN1 FMEN032053-5 87 5 0 Approved 5.000GILBARCO NN1 FMEN032053-5 89 5 0 Approved 5.000GILBARCO NN1 FMEN032053-5 93 5 0 Approved 5.000GILBARCO NN1 FMEN032053-6 87 6 0 Approved 5.000GILBARCO NN1 FMEN032053-6 89 6 0 Approved 5.000GILBARCO NN1 FMEN032053-6 93 6 0 Approved 5.000GILBARCO NN1 FMEN032051-7 87 7 0 Approved 5.000GILBARCO NN1 FMEN032051-7 89 7 0 Approved 5.000GILBARCO NN1 FMEN032051-7 93 7 0 Approved 5.000GILBARCO NN1 FMEN032051-8 87 8 0 Approved 5.000GILBARCO NN1 FMEN032051-8 89 8 0 Approved 5.000GILBARCO NN1 FMEN032055-9 87 9 0 Approved 5.000GILBARCO NN1 FMEN032055-9 89 9 0 Approved 5.000
Page 365 of 466
Inspector Acknowledged Receipt: CHERYL CUTRIGHT
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 FMEN032055-9 93 9 0 Approved 5.000GILBARCO NN1 FMEN032055-10 87 10 0 Approved 5.000GILBARCO NN1 FMEN032055-10 89 10 0 Approved 5.000GILBARCO NN1 FMEN032055-10 93 10 0 Approved 5.000GILBARCO NN1 FMEN032054-11 87 11 0 Approved 5.000GILBARCO NN1 FMEN032054-11 89 11 0 Approved 5.000GILBARCO NN1 FMEN032054-11 93 11 0 Approved 5.000GILBARCO NN1 FMEN032054-12 87 12 0 Approved 5.000GILBARCO NN1 FMEN032054-12 89 12 0 Approved 5.000GILBARCO NN1 FMEN032054-12 93 12 0 Approved 5.000GILBARCO NL1 FMEN032056-1 87 1 0 Approved 5.000GILBARCO NL1 FMEN032056-1 89 1 0 Approved 5.000GILBARCO NL1 FMEN032056-1 93 1 0 Approved 5.000GILBARCO NL1 FMEN032056-1 Diesel 1 0 Approved 5.000GILBARCO NL1 FMEN032056-2 87 2 0 Approved 5.000GILBARCO NL1 FMEN032056-2 89 2 0 Approved 5.000GILBARCO NL1 FMEN032056-2 93 2 0 Approved 5.000GILBARCO NL1 FMEN032056-2 Diesel 2 0 Approved 5.000
Device Product Used: 190. Insp Product Used: . Tot Product Used: 190.Grade Prod Used87 60.0089 60.0093 60.00Diesel 10.00
Billing Address:
,
Notes:
Page 366 of 466
Inspector Acknowledged Receipt: CHERYL CUTRIGHT
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/13/2011 Business ID: 00021473 Inspection: AU001531Business: FAST STOP 1 Store #:
2301 MECHANICSVILLE TNPK Phone: (804)782-9326Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
12/13/11 02:28 PM 0:00 0:00 0:00 C-9219Total: 0:00 0:00 0:00
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B05 PA037479-8 87 8 0 Condemned 0.000
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 367 of 466
Inspector Acknowledged Receipt: DAVID ALLISON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 368 of 466
Inspector Acknowledged Receipt: DAVID ALLISON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/14/2011 Business ID: 00501021 Inspection: AU001532Business: WAWA Store #: 8617
11052 W. BROAD Phone: 804-527-8302Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 36 36Gas Station 1 1Small Capacity Scale 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 LUEN177264-1 87 1 0 Approved 5.000GILBARCO NN1 LUEN177265-12 87 12 0 Approved 5.000GILBARCO NN1 LUEN177264-1 89 1 0 Approved 5.000GILBARCO NN1 LUEN177264-1 93 1 0 Approved 5.000GILBARCO NN1 LUEN177264-2 87 2 0 Approved 5.000GILBARCO NN1 LUEN177264-2 89 2 0 Approved 5.000GILBARCO NN1 LUEN177264-2 93 2 0 Approved 5.000GILBARCO NN1 LUEN177262-3 87 3 0 Approved 5.000GILBARCO NN1 LUEN177262-3 89 3 0 Approved 5.000GILBARCO NN1 LUEN177262-3 93 3 0 Approved 5.000GILBARCO NN1 LUEN177262-4 87 4 0 Approved 5.000GILBARCO NN1 LUEN177262-4 89 4 0 Approved 5.000GILBARCO NN1 LUEN177262-4 93 4 0 Approved 5.000GILBARCO NN1 LUEN177261-5 87 5 0 Approved 5.000GILBARCO NN1 LUEN177261-5 89 5 0 Approved 5.000GILBARCO NN1 LUEN177261-5 93 5 0 Approved 5.000GILBARCO NN1 LUEN177261-6 87 6 0 Approved 5.000GILBARCO NN1 LUEN177261-6 89 6 0 Approved 5.000GILBARCO NN1 LUEN177261-6 93 6 0 Approved 5.000
Page 369 of 466
Inspector Acknowledged Receipt: VAL WAITE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 LUEN177263-7 87 7 0 Approved 5.000GILBARCO NN1 LUEN177263-7 89 7 0 Approved 5.000GILBARCO NN1 LUEN177263-7 93 7 0 Approved 5.000GILBARCO NN1 LUEN177263-8 87 8 0 Approved 5.000GILBARCO NN1 LUEN177263-8 89 8 0 Approved 5.000GILBARCO NN1 LUEN177263-8 93 8 0 Approved 5.000GILBARCO NN1 LUEN177260-9 87 9 0 Approved 5.000GILBARCO NN1 LUEN177260-9 89 9 0 Approved 5.000GILBARCO NN1 LUEN177260-9 93 9 0 Approved 5.000GILBARCO NN1 LUEN177260-10 87 10 0 Approved 5.000GILBARCO NN1 LUEN177260-10 89 10 0 Approved 5.000GILBARCO NN1 LUEN177260-10 93 10 0 Approved 5.000GILBARCO NN1 LUEN177265-11 87 11 0 Approved 5.000GILBARCO NN1 LUEN177265-11 89 11 0 Approved 5.000GILBARCO NN1 LUEN177265-11 93 11 0 Approved 5.000GILBARCO NN1 LUEN177265-12 89 12 0 Approved 5.000GILBARCO NN1 LUEN177265-12 93 12 0 Approved 5.000
Device Product Used: 180. Insp Product Used: . Tot Product Used: 180.Grade Prod Used87 60.0089 60.0093 60.00
Billing Address:
,
Notes:
Page 370 of 466
Inspector Acknowledged Receipt: VAL WAITE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/14/2011 Business ID: 00113956 Inspection: AU001533Business: 7-ELEVEN Store #: #32603
11480 W BROAD ST Phone: 804-364-4108Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 36 36Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO 7B30 PA18024-9 89 9 0 Approved 5.000GILBARCO 7B30 PA18026-1 87 1 0 Approved 5.000GILBARCO 7B30 PA18027-3 93 3 0 Approved 5.000GILBARCO 7B30 PA18026-1 89 1 0 Approved 5.000GILBARCO 7B30 PA18026-1 93 1 0 Approved 5.000GILBARCO 7B30 PA18026-2 87 2 0 Approved 5.000GILBARCO 7B30 PA18026-2 89 2 0 Approved 5.000GILBARCO 7B30 PA18026-2 93 2 0 Approved 5.000GILBARCO 7B30 PA18027-3 87 3 0 Approved 5.000GILBARCO 7B30 PA18027-3 89 3 0 Approved 5.000GILBARCO 7B30 PA18027-4 87 4 0 Approved 5.000GILBARCO 7B30 PA18027-4 89 4 0 Approved 5.000GILBARCO 7B30 PA18027-4 93 4 0 Approved 5.000GILBARCO 7B30 PA18022-5 87 5 0 Approved 5.000GILBARCO 7B30 PA18022-5 89 5 0 Approved 5.000GILBARCO 7B30 PA18022-5 93 5 0 Approved 5.000GILBARCO 7B30 PA18022-6 87 6 0 Approved 5.000GILBARCO 7B30 PA18022-6 89 6 0 Approved 5.000GILBARCO 7B30 PA18022-6 93 6 0 Approved 5.000GILBARCO 7B30 PA18025-7 87 7 0 Approved 5.000
Page 371 of 466
Inspector Acknowledged Receipt: LAKSHMI BABU
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO 7B30 PA18025-7 89 7 0 Approved 5.000GILBARCO 7B30 PA18025-7 93 7 0 Approved 5.000GILBARCO 7B30 PA18025-8 87 8 0 Approved 5.000GILBARCO 7B30 PA18025-8 89 8 0 Approved 5.000GILBARCO 7B30 PA18025-8 93 8 0 Approved 5.000GILBARCO 7B30 PA18024-9 87 9 0 Approved 5.000GILBARCO 7B30 PA18024-9 93 9 0 Approved 5.000GILBARCO 7B30 PA18024-10 87 10 0 Approved 5.000GILBARCO 7B30 PA18024-10 89 10 0 Approved 5.000GILBARCO 7B30 PA18024-10 93 10 0 Approved 5.000GILBARCO 7B30 PA18023-11 87 11 0 Approved 5.000GILBARCO 7B30 PA18023-11 89 11 0 Approved 5.000GILBARCO 7B30 PA18023-11 93 11 0 Approved 5.000GILBARCO 7B30 PA18023-12 87 12 0 Approved 5.000GILBARCO 7B30 PA18023-12 89 12 0 Approved 5.000GILBARCO 7B30 PA18023-12 93 12 0 Approved 5.000
Device Product Used: 180. Insp Product Used: . Tot Product Used: 180.Grade Prod Used87 60.0089 60.0093 60.00
Billing Address:
,
Notes:
Page 372 of 466
Inspector Acknowledged Receipt: LAKSHMI BABU
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/15/2011 Business ID: 00112020 Inspection: AU001534Business: MILLER MART Store #: #67
11301 NUCKOLS RD Phone: 804-270-5061Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23059 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 38 35 3Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 EN016740-A 87 9 0 Approved 5.000 GILBARCO NN1 EN016740-A 89 9 0 Approved 5.000 GILBARCO NN1 EN016740-A 93 9 0 Approved 5.000 GILBARCO NN1 EN016740-B 87 10 0 Approved 5.000 GILBARCO NN1 EN016740-B 89 10 0 Approved 5.000 GILBARCO NN1 EN016740-B 93 10 0 Approved 5.000 GILBARCO NN1 EN016741-A 87 3 0 Approved 5.000 GILBARCO NN1 EN016741-A 89 3 0 Approved 5.000 GILBARCO NN1 EN016741-A 93 3 0 Approved 5.000 GILBARCO NN1 EN016741-B 87 4 0 Approved 5.000 GILBARCO NN1 EN016741-B 89 4 0 Approved 5.000 GILBARCO NN1 EN016741-B 93 4 0 Approved 5.000 GILBARCO NN1 EN016742-A 87 5 0 Approved 5.000 GILBARCO NN1 EN016742-A 89 5 0 Approved 5.000 GILBARCO NN1 EN016742-A 93 5 0 Approved 5.000 GILBARCO NN1 EN016742-B 87 6 0 Approved 5.000 GILBARCO NN1 EN016742-B 89 6 0 Approved 5.000 GILBARCO NN1 EN016742-B 93 6 0 Approved 5.000 GILBARCO NN1 EN016743-A 87 7 0 Approved 5.000 GILBARCO NN1 EN016743-A 89 7 0 Approved 5.000
Page 373 of 466
Inspector Acknowledged Receipt: aSHLEY wHITE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 EN016743-A 93 7 0 Approved 5.000 GILBARCO NN1 EN016743-B 87 8 -13 Rejected 5.000 GILBARCO NN1 EN016743-B 89 8 13 Rejected 5.000 GILBARCO NN1 EN016743-B 93 8 -18 Rejected 5.000 GILBARCO NN1 EN016744-A 87 11 0 Approved 5.000 GILBARCO NN1 EN016744-A 89 11 0 Approved 5.000 GILBARCO NN1 EN016744-A 93 11 0 Approved 5.000 GILBARCO NN1 EN016744-B 87 12 0 Approved 5.000 GILBARCO NN1 EN016744-B 89 12 0 Approved 5.000 GILBARCO NN1 EN016744-B 93 12 0 Approved 5.000GILBARCO NL1 EN016739-A 87 1 0 Approved 5.000GILBARCO NL1 EN016739-A 89 1 0 Approved 5.000GILBARCO NL1 EN016739-A 93 1 0 Approved 5.000GILBARCO NL1 EN016739-A Diesel 1 0 Approved 5.000GILBARCO NL1 EN016739-B 87 2 0 Approved 5.000GILBARCO NL1 EN016739-B 89 2 0 Approved 5.000GILBARCO NL1 EN016739-B 93 2 0 Approved 5.000GILBARCO NL1 EN016739-B Diesel 2 0 Approved 5.000
Device Product Used: 190. Insp Product Used: . Tot Product Used: 190.Grade Prod Used87 60.0089 60.0093 60.00Diesel 10.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 374 of 466
Inspector Acknowledged Receipt: aSHLEY wHITE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 375 of 466
Inspector Acknowledged Receipt: aSHLEY wHITE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/15/2011 Business ID: 00163063 Inspection: AU001535Business: WOODFIN EXXON Store #:
10950 NUCKOLS RD Phone: 804-934-0144Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 36 36Gas Station 1 1Small Capacity Scale 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 1/390D4/GOUY 723706-1 87 1 0 Approved 5.000WAYNE 1/390D4/GOUY 723706-1 89 1 0 Approved 5.000WAYNE 1/390D4/GOUY 723706-1 93 1 0 Approved 5.000WAYNE 1/390D4/GOUY 723706-2 87 2 0 Approved 5.000WAYNE 1/390D4/GOUY 723706-2 89 2 0 Approved 5.000WAYNE 1/390D4/GOUY 723706-2 93 2 0 Approved 5.000WAYNE 1/390D4/GOUY 723703-3 87 3 0 Approved 5.000WAYNE 1/390D4/GOUY 723703-3 89 3 0 Approved 5.000WAYNE 1/390D4/GOUY 723703-3 93 3 0 Approved 5.000WAYNE 1/390D4/GOUY 723703-4 87 4 0 Approved 5.000WAYNE 1/390D4/GOUY 723703-4 89 4 0 Approved 5.000WAYNE 1/390D4/GOUY 723703-4 93 4 0 Approved 5.000WAYNE 1/390D4/GOUY 723705-5 87 5 0 Approved 5.000WAYNE 1/390D4/GOUY 723705-5 89 5 0 Approved 5.000WAYNE 1/390D4/GOUY 723705-5 93 5 0 Approved 5.000WAYNE 1/390D4/GOUY 723705-6 87 6 0 Approved 5.000WAYNE 1/390D4/GOUY 723705-6 89 6 0 Approved 5.000WAYNE 1/390D4/GOUY 723705-6 93 6 0 Approved 5.000WAYNE 1/390D4/GOUY 723702-7 87 7 0 Approved 5.000
Page 376 of 466
Inspector Acknowledged Receipt: HSINGH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 1/390D4/GOUY 723702-7 89 7 0 Approved 5.000WAYNE 1/390D4/GOUY 723702-7 93 7 0 Approved 5.000WAYNE 1/390D4/GOUY 723702-8 87 8 0 Approved 5.000WAYNE 1/390D4/GOUY 723702-8 89 8 0 Approved 5.000WAYNE 1/390D4/GOUY 723702-8 93 8 0 Approved 5.000WAYNE 1/390D4/GOUY 723704-9 87 9 0 Approved 5.000WAYNE 1/390D4/GOUY 723704-9 89 9 0 Approved 5.000WAYNE 1/390D4/GOUY 723704-9 93 9 0 Approved 5.000WAYNE 1/390D4/GOUY 723704-10 87 10 0 Approved 5.000WAYNE 1/390D4/GOUY 723704-10 89 10 0 Approved 5.000WAYNE 1/390D4/GOUY 723704-10 93 10 0 Approved 5.000WAYNE 1/390D4/GOUY 723707-11 87 11 0 Approved 5.000WAYNE 1/390D4/GOUY 723707-11 89 11 0 Approved 5.000WAYNE 1/390D4/GOUY 723707-11 93 11 0 Approved 5.000WAYNE 1/390D4/GOUY 723707-12 87 12 0 Approved 5.000WAYNE 1/390D4/GOUY 723707-12 89 12 0 Approved 5.000WAYNE 1/390D4/GOUY 723707-12 93 12 0 Approved 5.000
Device Product Used: 180. Insp Product Used: . Tot Product Used: 180.Grade Prod Used87 60.0089 60.0093 60.00
Billing Address:
,
Notes:
Page 377 of 466
Inspector Acknowledged Receipt: HSINGH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/16/2011 Business ID: 00244203 Inspection: AU001536Business: CHAMBERLAYNE EXXON Store #:
5609 CHAMBERLAYNE RD Phone: (804)264-0202Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23323 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 26 26Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO AK1220 CA006507-1 87 1 0 Approved 5.000GILBARCO AK1220 CA006507-1 89 1 0 Approved 5.000GILBARCO AK1220 CA006507-1 93 1 0 Approved 5.000GILBARCO AK1220 CA006507-2 87 2 0 Approved 5.000GILBARCO AK1220 CA006507-2 89 2 0 Approved 5.000GILBARCO AK1220 CA006507-2 93 2 0 Approved 5.000GILBARCO AK1220 DA077106-3 87 3 0 Approved 5.000GILBARCO AK1220 DA077106-3 89 3 0 Approved 5.000GILBARCO AK1220 DA077106-3 93 3 0 Approved 5.000GILBARCO AK1220 DA077106-4 87 4 0 Approved 5.000GILBARCO AK1220 DA077106-4 89 4 0 Approved 5.000GILBARCO AK1220 DA077106-4 93 4 0 Approved 5.000GILBARCO AK1220 CA006599-5 87 5 0 Approved 5.000GILBARCO AK1220 CA006599-5 89 5 0 Approved 5.000GILBARCO AK1220 CA006599-5 93 5 0 Approved 5.000GILBARCO AK1220 CA006599-6 87 6 0 Approved 5.000GILBARCO AK1220 CA006599-6 89 6 0 Approved 5.000GILBARCO AK1220 CA006599-6 93 6 0 Approved 5.000GILBARCO AK1220 CA004795-7 87 7 0 Approved 5.000GILBARCO AK1220 CA004795-7 89 7 0 Approved 5.000
Page 378 of 466
Inspector Acknowledged Receipt: NOUR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO AK1220 CA004795-7 93 7 0 Approved 5.000GILBARCO AK1220 CA004795-8 87 8 0 Approved 5.000GILBARCO AK1220 CA004795-8 89 8 0 Approved 5.000GILBARCO AK1220 CA004795-8 93 8 0 Approved 5.000GILBARCO B21 PA014502-9 Diesel 9 0 Approved 5.000GILBARCO B21 PA014502-10 Diesel 10 0 Approved 5.000
Device Product Used: 130. Insp Product Used: . Tot Product Used: 130.Grade Prod Used87 40.0089 40.0093 40.00Diesel 10.00
Billing Address:
,
Notes:
Page 379 of 466
Inspector Acknowledged Receipt: NOUR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/19/2011 Business ID: 00110881 Inspection: AU001538Business: WAWA Store #: #677
8800 BROOK RD Phone: 804-264-4698Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 48 47 1Gas Station 1 1Small Capacity Scale 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA225209-15 87 15 0 Approved 5.000GILBARCO B79 PA225211-7 89 7 0 Condemned 5.000GILBARCO B79 PA225212-11 87 11 0 Approved 5.000GILBARCO B79 PA225212-12 87 12 0 Approved 5.000GILBARCO B79 PA225213-13 87 13 0 Approved 5.000GILBARCO B79 PA225214-1 87 1 0 Approved 5.000GILBARCO B79 PA225209-16 89 16 0 Approved 5.000GILBARCO B79 PA225213-14 87 14 0 Approved 5.000GILBARCO B79 PA225214-1 89 1 0 Approved 5.000GILBARCO B79 PA225214-1 93 1 0 Approved 5.000GILBARCO B79 PA225214-2 87 2 0 Approved 5.000GILBARCO B79 PA225214-2 89 2 0 Approved 5.000GILBARCO B79 PA225214-2 93 2 0 Approved 5.000GILBARCO B79 PA225211-3 87 3 0 Approved 5.000GILBARCO B79 PA225211-3 89 3 0 Approved 5.000GILBARCO B79 PA225211-3 93 3 0 Approved 5.000GILBARCO B79 PA225211-4 87 4 0 Approved 5.000GILBARCO B79 PA225211-4 89 4 0 Approved 5.000GILBARCO B79 PA225211-4 93 4 0 Approved 5.000
Page 380 of 466
Inspector Acknowledged Receipt: GINA HOWARD
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA225207-5 87 5 0 Approved 5.000GILBARCO B79 PA225207-5 89 5 0 Approved 5.000GILBARCO B79 PA225207-5 93 5 0 Approved 5.000GILBARCO B79 PA225207-6 87 6 0 Approved 5.000GILBARCO B79 PA225207-6 89 6 0 Approved 5.000GILBARCO B79 PA225207-6 93 6 0 Approved 5.000GILBARCO B79 PA225211-7 87 7 0 Approved 5.000GILBARCO B79 PA225211-7 93 7 0 Approved 5.000GILBARCO B79 PA225211-8 87 8 0 Approved 5.000GILBARCO B79 PA225211-8 89 8 0 Approved 5.000GILBARCO B79 PA225211-8 93 8 0 Approved 5.000GILBARCO B79 PA225208-9 87 9 0 Approved 5.000GILBARCO B79 PA225208-9 89 9 0 Approved 5.000GILBARCO B79 PA225208-9 93 9 0 Approved 5.000GILBARCO B79 PA225208-10 87 10 0 Approved 5.000GILBARCO B79 PA225208-10 89 10 0 Approved 5.000GILBARCO B79 PA225208-10 93 10 0 Approved 5.000GILBARCO B79 PA225212-11 89 11 0 Approved 5.000GILBARCO B79 PA225212-11 93 11 0 Approved 5.000GILBARCO B79 PA225212-12 89 12 0 Approved 5.000GILBARCO B79 PA225212-12 93 12 0 Approved 5.000GILBARCO B79 PA225213-13 89 13 0 Approved 5.000GILBARCO B79 PA225213-13 93 13 0 Approved 5.000GILBARCO B79 PA225213-14 89 14 0 Approved 5.000GILBARCO B79 PA225213-14 93 14 0 Approved 5.000GILBARCO B79 PA225209-15 89 15 0 Approved 5.000GILBARCO B79 PA225209-15 93 15 0 Approved 5.000GILBARCO B79 PA225209-16 87 16 0 Approved 5.000GILBARCO B79 PA225209-16 93 16 0 Approved 5.000
Device Product Used: 240. Insp Product Used: . Tot Product Used: 240.Grade Prod Used87 80.0089 80.0093 80.00
Page 381 of 466
Inspector Acknowledged Receipt: GINA HOWARD
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357
Page 382 of 466
Inspector Acknowledged Receipt: GINA HOWARD
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 383 of 466
Inspector Acknowledged Receipt: GINA HOWARD
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/20/2011 Business ID: 00163589 Inspection: AU001540Business: ROYAL MART Store #: #7
8920 W BROAD ST Phone: (804)346-9293Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 28 28Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NG1 177624-5 87 5 0 Approved 5.000GILBARCO NGO 177621-8 87 4 0 Approved 5.000GILBARCO NG1 177624-5 89 5 0 Approved 5.000GILBARCO NGO 177621-8 89 4 0 Approved 5.000GILBARCO NG1 177624-5 93 5 0 Approved 5.000GILBARCO NGO 177621-8 93 4 0 Approved 5.000GILBARCO NG1 177624-5 Diesel 5 0 Approved 5.000GILBARCO NG1 177624-6 87 6 0 Approved 5.000GILBARCO NG1 177624-6 89 6 0 Approved 5.000GILBARCO NG1 177624-6 93 6 0 Approved 5.000GILBARCO NG1 177624-6 Diesel 6 0 Approved 5.000GILBARCO NG1 192261-3 87 3 0 Approved 5.000GILBARCO NG1 192261-3 89 3 0 Approved 5.000GILBARCO NG1 192261-3 93 3 0 Approved 5.000GILBARCO NG1 192261-3 Diesel 3 0 Approved 5.000GILBARCO NG1 192261-4 87 4 0 Approved 5.000GILBARCO NG1 192261-4 89 4 0 Approved 5.000GILBARCO NG1 192261-4 93 4 0 Approved 5.000GILBARCO NG1 192261-4 Diesel 4 0 Approved 5.000GILBARCO NGO 177621-7 87 3 0 Approved 5.000
Page 384 of 466
Inspector Acknowledged Receipt: HARJIT SINGH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NGO 177621-7 89 3 0 Approved 5.000GILBARCO NGO 177621-7 93 3 0 Approved 5.000GILBARCO NGO 177622-1 87 1 0 Approved 5.000GILBARCO NGO 177622-1 89 1 0 Approved 5.000GILBARCO NGO 177622-1 93 1 0 Approved 5.000GILBARCO NGO 177622-2 87 2 0 Approved 5.000GILBARCO NGO 177622-2 89 2 0 Approved 5.000GILBARCO NGO 177622-2 93 2 0 Approved 5.000
Device Product Used: 140. Insp Product Used: . Tot Product Used: 140.Grade Prod Used87 40.0089 40.0093 40.00Diesel 20.00
Billing Address:
,
Notes:
Page 385 of 466
Inspector Acknowledged Receipt: HARJIT SINGH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/20/2011 Business ID: 00110365 Inspection: AU001541Business: UPPYS Store #: #47
3310 CHURCH RD Phone: 804-270-5686Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 30 27 3Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 MSEN141282-1 87 1 -4 Rejected 5.000GILBARCO NN1 MSEN141282-1 89 1 -4 Rejected 5.000GILBARCO NN1 MSEN141282-1 93 1 -5 Rejected 5.000GILBARCO NN1 MSEN141282-2 87 2 -4 Rejected 5.000GILBARCO NN1 MSEN141282-2 89 2 -3 Rejected 5.000GILBARCO NN1 MSEN141282-2 93 2 -5 Rejected 5.000GILBARCO NN1 MESN141279-3 87 3 -5 Rejected 5.000GILBARCO NN1 MESN141279-3 89 3 -5 Rejected 5.000GILBARCO NN1 MESN141279-3 93 3 -5 Rejected 5.000GILBARCO NN1 MSEN141279-4 87 4 -4 Rejected 5.000GILBARCO NN1 MSEN141279-4 89 4 -4 Rejected 5.000GILBARCO NN1 MSEN141279-4 93 4 -5 Rejected 5.000GILBARCO NN1 MSEN141280-5 87 5 0 Rejected 5.000GILBARCO NN1 MSEN141280-5 89 5 -2 Rejected 5.000GILBARCO NN1 MSEN141280-5 93 5 0 Rejected 5.000GILBARCO NN1 MSEN141280-6 87 6 -3 Rejected 5.000GILBARCO NN1 MSEN141280-6 89 6 -3 Rejected 5.000GILBARCO NN1 MSEN141280-6 93 6 0 Rejected 5.000GILBARCO NN1 MSEN141283-7 87 7 0 Rejected 5.000GILBARCO NN1 MSEN141283-7 89 7 0 Rejected 5.000
Page 386 of 466
Inspector Acknowledged Receipt: DARLENE BRAGG
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 MSEN141283-7 93 7 -2 Rejected 5.000GILBARCO NN1 MSEN141283-8 87 8 0 Rejected 5.000GILBARCO NN1 MSEN141283-8 89 8 0 Rejected 5.000GILBARCO NN1 MSEN141283-8 93 8 0 Rejected 5.000GILBARCO NN1 MSEN141281-9 87 9 -4 Rejected 5.000GILBARCO NN1 MSEN141281-9 89 9 -4 Rejected 5.000GILBARCO NN1 MSEN141281-9 93 9 -4 Rejected 5.000GILBARCO NN1 MSEN141281-10 87 10 0 Not Tested 0.000GILBARCO NN1 MSEN141281-10 89 10 0 Not Tested 0.000GILBARCO NN1 MSEN141281-10 93 10 0 Not Tested 0.000
Device Product Used: 135. Insp Product Used: . Tot Product Used: 135.Grade Prod Used87 45.0089 45.0093 45.00
Billing Address:
,
Notes:
Predominance of minus error all rejected.
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
Page 387 of 466
Inspector Acknowledged Receipt: DARLENE BRAGG
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 388 of 466
Inspector Acknowledged Receipt: DARLENE BRAGG
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 1/6/2012 Business ID: 00500711 Inspection: AU001550Business: 7-ELEVEN # 34136 Store #: # 34136
4475 LABURNUM AVE Phone: 804-652-0711Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 36 33 1 2Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 GTEN150873-1 87 1 -1 Approved 5.000GILBARCO NN1 GTEN150873-1 89 1 -1 Approved 5.000GILBARCO NN1 GTEN150873-1 93 1 -1 Approved 5.000GILBARCO NN1 GTEN150873-2 87 2 0 Approved 5.000GILBARCO NN1 GTEN150873-2 89 2 0 Approved 5.000GILBARCO NN1 GTEN150873-2 93 2 -1 Approved 5.000GILBARCO NN1 GTEN150876-3 87 3 -2 Condemned 5.000GILBARCO NN1 GTEN150876-3 89 3 -2 Condemned 5.000GILBARCO NN1 GTEN150876-3 93 3 -1 Approved 5.000GILBARCO NN1 GTEN150876-4 87 4 0 Approved 5.000GILBARCO NN1 GTEN150876-4 89 4 0 Approved 5.000GILBARCO NN1 GTEN150876-4 93 4 0 Approved 5.000GILBARCO NN1 GTEN150871-5 87 5 -2 Approved 5.000GILBARCO NN1 GTEN150871-5 89 5 -1 Approved 5.000GILBARCO NN1 GTEN150871-5 93 5 -2 Approved 5.000GILBARCO NN1 GTEN150871-6 87 6 -1 Approved 5.000GILBARCO NN1 GTEN150871-6 89 6 -2 Approved 5.000GILBARCO NN1 GTEN150871-6 93 6 -2 Approved 5.000GILBARCO NN1 GTEN150872-7 87 7 -1 Approved 5.000GILBARCO NN1 GTEN150872-7 89 7 -1 Approved 5.000
Page 389 of 466
Inspector Acknowledged Receipt: TALEB ALFAOURI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 GTEN150872-7 93 7 -1 Approved 5.000GILBARCO NN1 GTEN150872-8 87 8 -2 Approved 5.000GILBARCO NN1 GTEN150872-8 89 8 -3 Approved 5.000GILBARCO NN1 GTEN150872-8 93 8 -3 Approved 5.000GILBARCO NN1 GTEN150874-9 87 9 -2 Approved 5.000GILBARCO NN1 GTEN150874-9 89 9 -2 Approved 5.000GILBARCO NN1 GTEN150874-9 93 9 -2 Approved 5.000GILBARCO NN1 GTEN150874-10 87 10 -3 Approved 5.000GILBARCO NN1 GTEN150874-10 89 10 -3 Approved 5.000GILBARCO NN1 GTEN150874-10 93 10 -3 Approved 5.000GILBARCO NN1 GTEN150875-11 87 11 0 Approved 5.000GILBARCO NN1 GTEN150875-11 89 11 0 Approved 5.000GILBARCO NN1 GTEN150875-11 93 11 0 Rejected 5.000GILBARCO NN1 GTEN150875-12 87 12 -2 Approved 5.000GILBARCO NN1 GTEN150875-12 89 12 -2 Approved 5.000GILBARCO NN1 GTEN150875-12 93 12 -2 Approved 5.000
Device Product Used: 180. Insp Product Used: . Tot Product Used: 180.Grade Prod Used87 60.0089 60.0093 60.00
Billing Address:
,
Notes:
PUMP # 11 93 MISSING PRICE PER GALLON
PUMP # 3 87 & 89 METER CREEPING AT END OF SALE
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 390 of 466
Inspector Acknowledged Receipt: TALEB ALFAOURI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 391 of 466
Inspector Acknowledged Receipt: TALEB ALFAOURI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 1/10/2012 Business ID: 00111215 Inspection: AU001556Business: LAKESIDE CITGO Store #: #36
5301 LAKESIDE AVE Phone: 804-262-2181Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 18 18
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE V580D1/GOY 651468-1 87 1 0 Approved 0.000WAYNE V580D1/GOY 651468-2 87 2 0 Approved 0.000WAYNE V580D1/GOY 651468-1 89 1 0 Approved 0.000WAYNE V580D1/GOY 651468-1 93 1 0 Approved 0.000WAYNE V580D1/GOY 651468-2 89 2 0 Approved 0.000WAYNE V580D1/GOY 651468-2 93 2 0 Approved 0.000WAYNE V580D1/GOY 651467-3 87 3 0 Approved 0.000WAYNE V580D1/GOY 651467-3 89 3 0 Approved 0.000WAYNE V580D1/GOY 651467-3 93 3 0 Approved 0.000WAYNE V580D1/GOY 651467-4 87 4 0 Approved 0.000WAYNE V580D1/GOY 651467-4 89 4 0 Approved 0.000WAYNE V580D1/GOY 651467-4 93 4 0 Approved 0.000WAYNE V580D1/GOY 650918-5 87 5 0 Approved 0.000WAYNE V580D1/GOY 650918-5 89 5 0 Approved 0.000WAYNE V580D1/GOY 650918-5 93 5 0 Approved 0.000WAYNE V580D1/GOY 650918-6 87 6 0 Approved 0.000WAYNE V580D1/GOY 650918-6 89 6 0 Approved 0.000WAYNE V580D1/GOY 650918-6 93 6 0 Approved 0.000
Billing Address:
Page 392 of 466
Inspector Acknowledged Receipt: VIPUL DESI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
,
Notes:
Page 393 of 466
Inspector Acknowledged Receipt: VIPUL DESI
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 1/17/2012 Business ID: 00163072 Inspection: AU001560Business: PARHAM ROAD PIT STOP Store #: 542
807 E PARHAM RD Phone: (804)2616960Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23227 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
01/17/12 08:50 AM 09:19 AM 0:29 0:00 0:29 C - 28 Total: 0:29 0:00 0:29
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA188896-12 87 12 0 Not Tested 0.000
Billing Address:
,
Notes:
STATION HAS # 12 OUT OF SERVICE FOR REPAIRS NO ACTION TAKEN.
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 394 of 466
Inspector Acknowledged Receipt: TERESA BROWNIE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 395 of 466
Inspector Acknowledged Receipt: TERESA BROWNIE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 1/18/2012 Business ID: 00110576 Inspection: AU001564Business: ROYAL MART SHELL Store #:
1113 E NINE MILE RD Phone: (804)737-5688Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23075 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 42 41 1Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NG1 LUEN177705-3 Diesel 3 0 Approved 10.000GILBARCO NG1 LUEN177705-4 Diesel 4 0 Approved 5.000GILBARCO NGO LUEN177643-1 87 1 0 Approved 5.000GILBARCO NG1 LUEN177623-7 Diesel 7 0 Approved 5.000GILBARCO NGO LUEN177643-1 89 1 0 Approved 5.000GILBARCO NG1 LUEN177623-8 Diesel 8 0 Approved 5.000GILBARCO NGO LUEN177643-1 93 1 0 Approved 5.000GILBARCO NG1 LUEN176839-11 Diesel 11 0 Approved 5.000GILBARCO NGO LUEN177643-2 87 2 0 Approved 5.000
GILBARCO NG1 LUEN176839-12 Diesel 12 0 Rejected 5.000MISSING CETANE LABEL
GILBARCO NGO LUEN177643-2 89 2 0 Approved 5.000GILBARCO NGO LUEN177643-2 93 2 0 Approved 5.000GILBARCO NG1 LUEN177705-3 87 3 0 Approved 5.000GILBARCO NG1 LUEN177705-3 89 3 0 Approved 5.000GILBARCO NG1 LUEN177705-3 93 3 0 Approved 5.000GILBARCO NG1 LUEN177705-4 87 4 0 Approved 5.000GILBARCO NG1 LUEN177705-4 89 4 0 Approved 5.000GILBARCO NG1 LUEN177705-4 93 4 0 Approved 5.000GILBARCO NGO LUEN177644-5 87 5 0 Approved 5.000
Page 396 of 466
Inspector Acknowledged Receipt: ABDULLAH GMA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NGO LUEN177644-5 89 5 0 Approved 5.000GILBARCO NGO LUEN177644-5 93 5 0 Approved 5.000GILBARCO NGO LUEN177644-6 87 6 0 Approved 5.000GILBARCO NGO LUEN177644-6 89 6 0 Approved 5.000GILBARCO NGO LUEN177644-6 93 6 0 Approved 5.000GILBARCO NG1 LUEN177623-7 87 7 0 Approved 5.000GILBARCO NG1 LUEN177623-7 89 7 0 Approved 5.000GILBARCO NG1 LUEN177623-7 93 7 0 Approved 5.000GILBARCO NG1 LUEN177623-8 87 8 0 Approved 5.000GILBARCO NG1 LUEN177623-8 89 8 0 Approved 5.000GILBARCO NG1 LUEN177623-8 93 8 0 Approved 5.000GILBARCO NGO LUEN177642-9 87 9 0 Approved 5.000GILBARCO NGO LUEN177642-9 89 9 0 Approved 5.000GILBARCO NGO LUEN177642-9 93 9 0 Approved 5.000GILBARCO NGO LUEN177642-10 87 10 0 Approved 5.000GILBARCO NGO LUEN177642-10 89 10 0 Approved 5.000GILBARCO NGO LUEN177642-10 93 10 0 Approved 5.000GILBARCO NG1 LUEN176839-11 87 11 0 Approved 5.000GILBARCO NG1 LUEN176839-11 89 11 0 Approved 5.000GILBARCO NG1 LUEN176839-11 93 11 0 Approved 5.000GILBARCO NG1 LUEN176839-12 87 12 0 Approved 5.000GILBARCO NG1 LUEN176839-12 89 12 0 Approved 5.000GILBARCO NG1 LUEN176839-12 93 12 0 Approved 5.000
Device Product Used: 215. Insp Product Used: . Tot Product Used: 215.Grade Prod Used87 60.0089 60.0093 60.00Diesel 35.00
Billing Address:
,
Page 397 of 466
Inspector Acknowledged Receipt: ABDULLAH GMA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1
Page 398 of 466
Inspector Acknowledged Receipt: ABDULLAH GMA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 399 of 466
Inspector Acknowledged Receipt: ABDULLAH GMA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 1/19/2012 Business ID: 00110453 Inspection: AU001565Business: NINE MILE ROAD EXXON Store #:
3606 NINE MILE RD Phone: (804)222-8834Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 38 38Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 LPEN082186-1 87 1 0 Approved 5.000GILBARCO NN1 LPEN082186-1 89 1 0 Approved 5.000GILBARCO NN1 LPEN082186-1 93 1 0 Approved 5.000GILBARCO NN1 LPEN082186-2 87 2 0 Approved 5.000GILBARCO NN1 LPEN082186-2 89 2 0 Approved 5.000GILBARCO NN1 LPEN082186-2 93 2 0 Approved 5.000GILBARCO NN1 LPEN082183-3 87 3 0 Approved 5.000GILBARCO NN1 LPEN082183-3 89 3 0 Approved 5.000GILBARCO NN1 LPEN082183-3 93 3 0 Approved 5.000GILBARCO NN1 LPEN082183-4 87 4 0 Approved 5.000GILBARCO NN1 LPEN082183-4 89 4 0 Approved 5.000GILBARCO NN1 LPEN082183-4 93 4 0 Approved 5.000GILBARCO NN1 LPEN082185-5 87 5 0 Approved 5.000GILBARCO NN1 LPEN082185-5 89 5 0 Approved 5.000GILBARCO NN1 LPEN082185-5 93 5 0 Approved 5.000GILBARCO NN1 LPEN082185-6 87 6 0 Approved 5.000GILBARCO NN1 LPEN082185-6 89 6 0 Approved 5.000GILBARCO NN1 LPEN082185-6 93 6 0 Approved 5.000GILBARCO NN1 LPEN082182-7 87 7 0 Approved 5.000GILBARCO NN1 LPEN082182-7 89 7 0 Approved 5.000
Page 400 of 466
Inspector Acknowledged Receipt: PAREEN MERCHAND
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 LPEN082182-7 93 7 0 Approved 5.000GILBARCO NN1 LPEN082182-8 87 8 0 Approved 5.000GILBARCO NN1 LPEN082182-8 89 8 0 Approved 5.000GILBARCO NN1 LPEN082182-8 93 8 0 Approved 5.000GILBARCO NN1 LPEN082184-9 87 9 0 Approved 5.000GILBARCO NN1 LPEN082184-9 89 9 0 Approved 5.000GILBARCO NN1 LPEN082184-9 93 9 0 Approved 5.000GILBARCO NN1 LPEN082184-10 87 10 0 Approved 5.000GILBARCO NN1 LPEN082184-10 89 10 0 Approved 5.000GILBARCO NN1 LPEN082184-10 93 10 0 Approved 5.000GILBARCO NN1 LPEN082181-11 87 11 0 Approved 5.000GILBARCO NN1 LPEN082181-11 89 11 0 Approved 5.000GILBARCO NN1 LPEN082181-11 93 11 0 Approved 5.000GILBARCO NN1 LPEN082181-12 87 12 0 Approved 5.000GILBARCO NN1 LPEN082181-12 89 12 0 Approved 5.000GILBARCO NN1 LPEN082181-12 93 12 0 Approved 5.000 GILBARCO NP3 ANEN0045401-a Diesel 13 0 Approved 5.000 GILBARCO NP3 ANEN045401-b Diesel 14 0 Approved 5.000
Device Product Used: 190. Insp Product Used: . Tot Product Used: 190.Grade Prod Used87 60.0089 60.0093 60.00Diesel 10.00
Billing Address:
,
Notes:
Page 401 of 466
Inspector Acknowledged Receipt: PAREEN MERCHAND
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 1/19/2012 Business ID: 00111753 Inspection: AU001566Business: ZOTAS # 659 CITGO Store #: #659
501 S AIRPORT RD Phone: (804)328-5170Inspector: 325 MIKE TILLMAN
SANDSTON, VA 23150 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 27 27Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO N/A 5190-3 87 3 0 Approved 5.000GILBARCO N/A 57296-1 87 1 0 Approved 5.000GILBARCO N/A 57296-1 89 1 0 Approved 5.000GILBARCO N/A 57296-1 93 1 0 Approved 5.000GILBARCO N/A 57296-2 87 2 0 Approved 5.000GILBARCO N/A 57296-2 89 2 0 Approved 5.000GILBARCO N/A 57296-2 93 2 0 Approved 5.000GILBARCO N/A 5190-3 89 3 0 Approved 5.000GILBARCO N/A 5190-3 93 3 0 Approved 5.000GILBARCO N/A 5190-4 87 4 0 Approved 5.000GILBARCO N/A 5190-4 89 4 0 Approved 5.000GILBARCO N/A 5190-4 93 4 0 Approved 5.000GILBARCO N/A 5188-5 87 5 0 Approved 5.000GILBARCO N/A 5188-5 89 5 0 Approved 5.000GILBARCO N/A 5188-5 93 5 0 Approved 5.000GILBARCO N/A 5188-6 87 6 0 Approved 5.000GILBARCO N/A 5188-6 89 6 0 Approved 5.000GILBARCO N/A 5188-6 93 6 0 Approved 5.000GILBARCO N/A 5189-7 87 7 0 Approved 5.000GILBARCO N/A 5189-7 89 7 0 Approved 5.000
Page 402 of 466
Inspector Acknowledged Receipt: JAHID
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO N/A 5189-7 93 7 0 Approved 5.000GILBARCO N/A 5189-8 87 8 0 Approved 5.000GILBARCO N/A 5189-8 89 8 0 Approved 5.000GILBARCO N/A 5189-8 93 8 0 Approved 5.000GILBARCO NA 40625-9 Diesel 9 0 Approved 5.000GILBARCO NA 40622-10 Diesel 10 0 Approved 5.000GILBARCO NA 40623-11 Diesel 11 0 Approved 5.000
Device Product Used: 135. Insp Product Used: . Tot Product Used: 135.Grade Prod Used87 40.0089 40.0093 40.00Diesel 15.00
Billing Address:
,
Notes:
Page 403 of 466
Inspector Acknowledged Receipt: JAHID
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 1/19/2012 Business ID: 00022159 Inspection: AU001567Business: DANCO MINI MART Store #:
3301 WILLIAMSBURG RD Phone: (804)222-0102Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 22 14 4 4Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
BENNETT 4024 48106801-11 Diesel 11 15 Condemned 5.000BENNETT 4013 R7132 -12 Off Road Diesel 12 -11 Rejected 5.000GILBARCO 164SJ900NO DA052600-10 Kerosene 10 0 Approved 5.000 GILBARCO B7 PA122813-A 87 1 0 Approved 5.000 GILBARCO B7 PA122813-A 89 1 0 Approved 5.000 GILBARCO B7 PA122813-A 93 1 0 Approved 5.000 GILBARCO B7 PA122813-B 87 2 0 Approved 5.000 GILBARCO B7 PA122813-B 89 2 0 Approved 5.000 GILBARCO B7 PA122813-B 93 2 -8 Rejected 5.000 GILBARCO B7 RM017451-A 87 3 0 Approved 5.000 GILBARCO B7 RM017451-A 89 3 0 Approved 5.000 GILBARCO B7 RM017451-A 93 3 0 Approved 5.000 GILBARCO B7 RM017351-B 87 4 0 Approved 5.000 GILBARCO B7 RM017351-B 89 4 0 Approved 5.000 GILBARCO B7 RM017351-B 93 4 0 Approved 5.000 GILBARCO B7 PA127820-A 87 5 11 Rejected 5.000 GILBARCO B7 PA127820-A 89 5 11 Rejected 5.000 GILBARCO B7 PA127820-A 93 5 0 Approved 5.000 GILBARCO B7 PA127820-B 87 6 20 Condemned 5.000 GILBARCO B7 PA127820-B 89 6 20 Condemned 5.000
Page 404 of 466
Inspector Acknowledged Receipt: VINCENT HARVEY
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B7 PA127820-B 93 6 0 Approved 5.000WAYNE 51135 0169 Racing 7W 20 Condemned 5.000
Device Product Used: 110. Insp Product Used: . Tot Product Used: 110.Grade Prod Used87 30.0089 30.0093 30.00Diesel 5.00Kerosene 5.00Off Road Dies 5.00Racing 5.00
Billing Address:
,
Notes:
BRAND REGISTRATION VIOLATIONS ON ALL GRADES 87,89 93 &110 RACING FUELRACING FUEL NEEDS TO BE LABELED NOT FOR STREET USE ALSO
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANS
Page 405 of 466
Inspector Acknowledged Receipt: VINCENT HARVEY
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Service Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 406 of 466
Inspector Acknowledged Receipt: VINCENT HARVEY
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 1/24/2012 Business ID: 00113863 Inspection: AU001569Business: SAM'S CLUB Store #: #6343
9440 W BROAD ST Phone: 804-346-3031Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23294 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 24 18 6Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 3/D595D/G/D 44661-1 87 1 0 Approved 5.000WAYNE 3/D595D/G/D 44663-8 87 8 0 Approved 5.000WAYNE 3/D595D/G/D 44661-1 93 1 0 Approved 5.000WAYNE 3/D595D/G/D 44661-2 87 2 0 Approved 5.000WAYNE 3/D595D/G/D 44661-2 93 2 0 Approved 5.000WAYNE 3/D595D/G/D 44659-3 87 3 7 Rejected 5.000WAYNE 3/D595D/G/D 44659-3 93 3 0 Approved 5.000WAYNE 3/D595D/G/D 44659-4 87 4 11 Rejected 5.000WAYNE 3/D595D/G/D 44659-4 93 4 0 Approved 5.000WAYNE 3/D595D/G/D 44662-5 87 5 0 Approved 5.000WAYNE 3/D595D/G/D 44662-5 93 5 0 Approved 5.000WAYNE 3/D595D/G/D 44662-6 87 6 10 Rejected 5.000WAYNE 3/D595D/G/D 44662-6 93 6 0 Approved 5.000WAYNE 3/D595D/G/D 44663-7 87 7 0 Approved 5.000WAYNE 3/D595D/G/D 44663-7 93 7 0 Approved 5.000WAYNE 3/D595D/G/D 44663-8 93 8 0 Approved 5.000WAYNE 3/D595D/G/D 44660-9 87 9 0 Approved 5.000WAYNE 3/D595D/G/D 44660-9 93 9 8 Rejected 5.000WAYNE 3/D595D/G/D 44660-10 87 10 0 Approved 5.000WAYNE 3/D595D/G/D 44660-10 93 10 0 Approved 5.000
Page 407 of 466
Inspector Acknowledged Receipt: PAUL CHAPMAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 3/D595D/G/D 44656-11 87 11 7 Rejected 5.000WAYNE 3/D595D/G/D 44656-11 93 11 0 Approved 5.000WAYNE 3/D595D/G/D 44656-12 87 12 8 Rejected 5.000WAYNE 3/D595D/G/D 44656-12 93 12 0 Approved 5.000
Device Product Used: 120. Insp Product Used: . Tot Product Used: 120.Grade Prod Used87 60.0093 60.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Page 408 of 466
Inspector Acknowledged Receipt: PAUL CHAPMAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 409 of 466
Inspector Acknowledged Receipt: PAUL CHAPMAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 1/24/2012 Business ID: 00021599 Inspection: AU001570Business: BROAD ST MILLER MART Store #:
8430 W BROAD ST Phone: (804)346-9806Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 27 26 1Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H426BPMK1P1 PMP15069-7 87 7 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP15070-6 6 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP16064-1 87 1 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP16064-1 89 1 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP16064-1 93 1 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP16064-2 87 2 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP16064-2 89 2 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP16064-2 93 2 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP15082-3 87 3 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP15082-3 89 3 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP15082-3 93 3 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP15082-4 87 4 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP15082-4 89 4 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP15082-4 93 4 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP15072-5 87 5 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP15072-5 89 5 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP15072-5 93 5 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP15072-6 87 6 -5 Approved 10.000TOKHEIM H426BPMK1P1 PMP15072-6 89 6 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP15072-6 93 6 0 Approved 5.000
Page 410 of 466
Inspector Acknowledged Receipt: NIMISHA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H426BPMK1P1 PMP15069-7 89 7 0 Approved 10.000TOKHEIM H426BPMK1P1 PMP15069-7 93 7 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP15069-8 87 8 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP15069-8 89 8 0 Approved 5.000TOKHEIM H426BPMK1P1 PMP15069-8 93 8 0 Approved 5.000TOKHEIM 162L-RC-APC 056162103573-9 Diesel 9 0 Approved 5.000TOKHEIM 162L-RC-APC 035162105229-10 Kerosene 10 0 Not Tested 0.000
Device Product Used: 140. Insp Product Used: . Tot Product Used: 140.Grade Prod Used
5.0087 45.0089 45.0093 40.00Diesel 5.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANS
Page 411 of 466
Inspector Acknowledged Receipt: NIMISHA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Service Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 412 of 466
Inspector Acknowledged Receipt: NIMISHA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 1/24/2012 Business ID: 00111765 Inspection: AU001571Business: ZOTAS CITGO Store #: #662
7834 PARHAM RD Phone: (804)747-6090Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 25 25Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA094305-5 87 5 0 Approved 5.000GILBARCO B79 PA094306-2 87 2 0 Approved 5.000GILBARCO B79 PAO94306-1 87 1 0 Approved 5.000GILBARCO B79 PA094305-5 89 5 0 Approved 5.000GILBARCO B79 PAO94306-1 89 1 0 Approved 5.000GILBARCO B79 PA094305-5 93 5 0 Approved 5.000GILBARCO B79 PAO94306-1 93 1 0 Approved 5.000GILBARCO B79 PA094305-6 87 6 0 Approved 5.000GILBARCO B79 PA094305-6 89 6 0 Approved 5.000GILBARCO B79 PA094306-2 89 2 0 Approved 5.000GILBARCO B79 PA094306-2 93 2 0 Approved 5.000GILBARCO B79 PA094308-3 87 3 0 Approved 5.000GILBARCO B79 PA094308-3 89 3 0 Approved 5.000GILBARCO B79 PA094308-3 93 3 0 Approved 5.000GILBARCO B79 PA094308-4 87 4 0 Approved 5.000GILBARCO B79 PA094308-4 89 4 0 Approved 5.000GILBARCO B79 PA094308-4 93 4 0 Approved 5.000GILBARCO B79 PA094305-6 93 6 0 Approved 5.000GILBARCO B79 PA094307-7 87 7 0 Approved 5.000GILBARCO B79 PA094307-7 89 7 0 Approved 5.000
Page 413 of 466
Inspector Acknowledged Receipt: SYFUL ALAM
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA094307-7 93 7 0 Approved 5.000GILBARCO B79 PA094307-8 87 8 0 Approved 5.000GILBARCO B79 PA094307-8 89 8 0 Approved 5.000GILBARCO B79 PA094307-8 93 8 0 Approved 5.000GILBARCO JHA300 A077522 Diesel 0 Approved 5.000
Device Product Used: 125. Insp Product Used: . Tot Product Used: 125.Grade Prod Used87 40.0089 40.0093 40.00Diesel 5.00
Billing Address:
,
Notes:
Page 414 of 466
Inspector Acknowledged Receipt: SYFUL ALAM
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 1/25/2012 Business ID: 00022105 Inspection: AU001572Business: FAIRFIELD BP Store #:
5051 NINE MILE RD Phone: (804)737-7611Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 32 32Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B12 11996-1 87 1 0 Approved 5.000WAYNE B12 11996-1 89 1 0 Approved 5.000WAYNE B12 11996-1 93 1 0 Approved 5.000WAYNE B12 11996-2 87 2 0 Approved 5.000WAYNE B12 11996-2 89 2 0 Approved 5.000WAYNE B12 11996-2 93 2 0 Approved 5.000WAYNE B12 11993-3 87 3 0 Approved 5.000WAYNE B12 11993-3 89 3 0 Approved 5.000WAYNE B12 11993-3 93 3 0 Approved 5.000WAYNE B12 11993-4 87 4 0 Approved 5.000WAYNE B12 11993-4 89 4 0 Approved 5.000WAYNE B12 11993-4 93 4 0 Approved 5.000WAYNE B12 11994-5 87 5 0 Approved 5.000WAYNE B12 11994-5 89 5 0 Approved 5.000WAYNE B12 11994-5 93 5 0 Approved 5.000WAYNE B12 11994-6 87 6 0 Approved 5.000WAYNE B12 11994-6 89 6 0 Approved 5.000WAYNE B12 11994-6 93 6 0 Approved 5.000WAYNE B12 11995-7 87 7 0 Approved 5.000WAYNE B12 11995-7 89 7 0 Approved 5.000
Page 415 of 466
Inspector Acknowledged Receipt: HAQUE ADM
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B12 11995-7 93 7 0 Approved 5.000WAYNE B12 11995-8 87 8 0 Approved 5.000WAYNE B12 11995-8 89 8 0 Approved 5.000WAYNE B12 11995-8 93 8 0 Approved 5.000WAYNE B23 11997-9 87 9 0 Approved 5.000WAYNE B23 11997-9 89 9 0 Approved 5.000WAYNE B23 11997-9 93 9 0 Approved 5.000WAYNE B23 11997-9 Diesel 9 0 Approved 5.000WAYNE B23 11997-10 87 10 0 Approved 5.000WAYNE B23 11997-10 89 10 0 Approved 5.000WAYNE B23 11997-10 93 10 0 Approved 5.000WAYNE B23 11997-10 Diesel 10 0 Approved 5.000
Device Product Used: 160. Insp Product Used: . Tot Product Used: 160.Grade Prod Used87 50.0089 50.0093 50.00Diesel 10.00
Billing Address:
,
Notes:
Page 416 of 466
Inspector Acknowledged Receipt: HAQUE ADM
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 1/26/2012 Business ID: 00110353 Inspection: AU001574Business: WILLOW LAWN SERVICE CENTER Store #:
5312 W BROAD ST Phone: (804)288-9341Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23230 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 23 3 20Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA208030-1 87 1 0 Rejected 5.000GILBARCO B79 PA208030-1 89 1 0 Rejected 5.000GILBARCO B79 PA208030-1 93 1 0 Rejected 5.000GILBARCO B79 PA208030-2 87 2 0 Rejected 5.000GILBARCO B79 PA208030-2 89 2 0 Rejected 5.000GILBARCO B79 PA208030-2 93 2 0 Rejected 5.000GILBARCO B79 PA208029-3 87 3 0 Rejected 5.000GILBARCO B79 PA208029-3 89 3 0 Rejected 5.000GILBARCO B79 PA208029-3 93 3 0 Rejected 5.000GILBARCO B79 PA208029-4 87 4 0 Rejected 5.000GILBARCO B79 PA208029-4 89 4 0 Rejected 5.000GILBARCO B79 PA208029-4 93 4 0 Rejected 5.000GILBARCO B7C PA208031-5 87 5 0 Rejected 5.000GILBARCO B7C PA208031-5 89 5 0 Rejected 5.000GILBARCO B7C PA208031-5 93 5 0 Rejected 5.000GILBARCO B7C PA208031-5 Diesel 5 0 Rejected 5.000GILBARCO B7C PA208031-6 87 6 0 Rejected 5.000GILBARCO B7C PA208031-6 89 6 0 Rejected 5.000GILBARCO B7C PA208031-6 93 6 0 Rejected 5.000GILBARCO B7C PA208031-6 Diesel 6 0 Rejected 5.000
Page 417 of 466
Inspector Acknowledged Receipt: P MANCHAS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO 1549100280 AV19237-7 87 7 0 Approved 5.000GILBARCO 1549100280 DW6758-9 Kerosene 9 0 Approved 5.000GILBARCO 661S 6610790-8 Diesel 8 0 Approved 5.000
Device Product Used: 115. Insp Product Used: . Tot Product Used: 115.Grade Prod Used87 35.0089 30.0093 30.00Diesel 15.00Kerosene 5.00
Billing Address:
,
Notes:
OCTANE LABELING MISSING ON ALL PUMPS
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or
Page 418 of 466
Inspector Acknowledged Receipt: P MANCHAS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 419 of 466
Inspector Acknowledged Receipt: P MANCHAS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 1/27/2012 Business ID: 00022105 Inspection: AU001584Business: FAIRFIELD BP Store #:
5051 NINE MILE RD Phone: (804)737-7611Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
01/27/12 01:55 PM 02:15 PM 0:20 0:00 0:20 C-61 NO PROBLEM FOUNDTotal: 0:20 0:00 0:20
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B12 11996-1 89 1 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used89 5.00
Billing Address:
,
Notes:
Page 420 of 466
Inspector Acknowledged Receipt: HARSHA PANCHASARA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 1/31/2012 Business ID: 00113956 Inspection: AU001596Business: 7-ELEVEN Store #: #32603
11480 W BROAD ST Phone: 804-364-4108Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
01/31/12 01:20 PM 02:35 PM 1:15 0:00 1:15 C-70 NO PROBLEM FOUNDTotal: 1:15 0:00 1:15
Class Actv App Rej Con CwC NTLiquid Measuring Device 12 12
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO 7B30 PA18026-1 87 1 0 Approved 0.000GILBARCO 7B30 PA18026-2 87 2 0 Approved 0.000GILBARCO 7B30 PA18027-3 87 3 0 Approved 0.000GILBARCO 7B30 PA18027-4 87 4 0 Approved 0.000GILBARCO 7B30 PA18022-5 87 5 0 Approved 0.000GILBARCO 7B30 PA18022-6 87 6 0 Approved 0.000GILBARCO 7B30 PA18025-7 87 7 0 Approved 0.000GILBARCO 7B30 PA18025-8 87 8 0 Approved 0.000GILBARCO 7B30 PA18024-9 87 9 0 Approved 0.000GILBARCO 7B30 PA18024-10 87 10 0 Approved 0.000GILBARCO 7B30 PA18023-11 87 11 0 Approved 0.000GILBARCO 7B30 PA18023-12 87 12 0 Approved 0.000
Page 421 of 466
Inspector Acknowledged Receipt: FARHAD HOSSAIN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Billing Address:
,
Notes:
87 GRADES WERE CHECKED ON ALL DISPENSERS AND ALL WERE FOUND TO BE IN WORKING ORDER AT THIS TIME. NO PROBLEMS WAS FOUND.
Page 422 of 466
Inspector Acknowledged Receipt: FARHAD HOSSAIN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 2/3/2012 Business ID: 00021214 Inspection: AU001600Business: VIRGINIA CENTER SHELL Store #:
9999 BROOK RD Phone: (804)281-0800Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23059 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 3 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 DPEN069202-4 87 4 0 Approved 5.000GILBARCO NN1 DPEN069202-4 89 4 0 Approved 5.000GILBARCO NN1 DPEN069202-4 93 4 0 Approved 5.000
Device Product Used: 15. Insp Product Used: . Tot Product Used: 15.Grade Prod Used87 5.0089 5.0093 5.00
Billing Address:
,
Notes:
Page 423 of 466
Inspector Acknowledged Receipt: BHIKHU THAKKAAR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 2/3/2012 Business ID: 00110881 Inspection: AU001601Business: WAWA Store #: #677
8800 BROOK RD Phone: 804-264-4698Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA225211-7 89 7 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used89 5.00
Billing Address:
,
Notes:
Page 424 of 466
Inspector Acknowledged Receipt: DARLENE HARRIS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 2/3/2012 Business ID: 00112020 Inspection: AU001602Business: MILLER MART Store #: #67
11301 NUCKOLS RD Phone: 804-270-5061Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23059 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 3 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 EN016743-B 87 8 6 Approved 5.000 GILBARCO NN1 EN016743-B 89 8 0 Approved 5.000 GILBARCO NN1 EN016743-B 93 8 0 Approved 5.000
Device Product Used: 15. Insp Product Used: . Tot Product Used: 15.Grade Prod Used87 5.0089 5.0093 5.00
Billing Address:
,
Notes:
Page 425 of 466
Inspector Acknowledged Receipt:
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 2/3/2012 Business ID: 00111207 Inspection: AU001603Business: EAST COAST Store #: #59
9800 W BROAD ST Phone: (804)370-8110Inspector: 325 MIKE TILLMAN
GLEN ALLEN, VA 23060 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 2 2
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
TOKHEIM H 426B 071TCS61648-6 87 6 0 Approved 5.000TOKHEIM H 426B 071TCS61648-6 93 6 0 Approved 5.000
Device Product Used: 10. Insp Product Used: . Tot Product Used: 10.Grade Prod Used87 5.0093 5.00
Billing Address:
,
Notes:
Page 426 of 466
Inspector Acknowledged Receipt:
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 2/3/2012 Business ID: 00021386 Inspection: AU001604Business: REGENCY SHELL /SMO Store #:
1501 N PARHAM RD Phone: (804)282-4470Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 2 2
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B87 PA211618-3 Diesel 3 0 Approved 5.000GILBARCO B87 PA211618-4 Diesel 4 0 Approved 5.000
Device Product Used: 10. Insp Product Used: . Tot Product Used: 10.Grade Prod UsedDiesel 10.00
Billing Address:
,
Notes:
Page 427 of 466
Inspector Acknowledged Receipt: KHAIRUL B. M. BORHAN
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 2/3/2012 Business ID: 00500711 Inspection: AU001605Business: 7-ELEVEN # 34136 Store #: # 34136
4475 LABURNUM AVE Phone: 804-652-0711Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 3 3
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 GTEN150876-3 87 3 0 Approved 0.000GILBARCO NN1 GTEN150876-3 89 3 0 Approved 0.000GILBARCO NN1 GTEN150875-11 93 11 0 Approved 0.000
Billing Address:
,
Notes:
Page 428 of 466
Inspector Acknowledged Receipt: ALIALFOUR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 2/8/2012 Business ID: 00110365 Inspection: AU001610Business: UPPYS Store #: #47
3310 CHURCH RD Phone: 804-270-5686Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23233 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 30 30Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 MSEN141282-1 87 1 0 Approved 5.000GILBARCO NN1 MSEN141282-1 89 1 0 Approved 5.000GILBARCO NN1 MSEN141282-1 93 1 0 Approved 5.000GILBARCO NN1 MSEN141282-2 87 2 0 Approved 5.000GILBARCO NN1 MSEN141282-2 89 2 0 Approved 5.000GILBARCO NN1 MSEN141282-2 93 2 0 Approved 5.000GILBARCO NN1 MESN141279-3 87 3 0 Approved 5.000GILBARCO NN1 MESN141279-3 89 3 0 Approved 5.000GILBARCO NN1 MESN141279-3 93 3 0 Approved 5.000GILBARCO NN1 MSEN141279-4 87 4 0 Approved 5.000GILBARCO NN1 MSEN141279-4 89 4 0 Approved 5.000GILBARCO NN1 MSEN141279-4 93 4 0 Approved 5.000GILBARCO NN1 MSEN141280-5 87 5 0 Approved 5.000GILBARCO NN1 MSEN141280-5 89 5 0 Approved 5.000GILBARCO NN1 MSEN141280-5 93 5 0 Approved 5.000GILBARCO NN1 MSEN141280-6 87 6 0 Approved 5.000GILBARCO NN1 MSEN141280-6 89 6 0 Approved 5.000GILBARCO NN1 MSEN141280-6 93 6 0 Approved 5.000GILBARCO NN1 MSEN141283-7 87 7 0 Approved 5.000GILBARCO NN1 MSEN141283-7 89 7 0 Approved 5.000
Page 429 of 466
Inspector Acknowledged Receipt: P. LAMBERT
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 MSEN141283-7 93 7 0 Approved 5.000GILBARCO NN1 MSEN141283-8 87 8 0 Approved 5.000GILBARCO NN1 MSEN141283-8 89 8 0 Approved 5.000GILBARCO NN1 MSEN141283-8 93 8 0 Approved 5.000GILBARCO NN1 MSEN141281-9 87 9 0 Approved 5.000GILBARCO NN1 MSEN141281-9 89 9 0 Approved 5.000GILBARCO NN1 MSEN141281-9 93 9 0 Approved 5.000GILBARCO NN1 MSEN141281-10 87 10 0 Approved 5.000GILBARCO NN1 MSEN141281-10 89 10 0 Approved 5.000GILBARCO NN1 MSEN141281-10 93 10 0 Approved 5.000
Device Product Used: 150. Insp Product Used: . Tot Product Used: 150.Grade Prod Used87 50.0089 50.0093 50.00
Billing Address:
,
Notes:
Page 430 of 466
Inspector Acknowledged Receipt: P. LAMBERT
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 2/14/2012 Business ID: 00110576 Inspection: AU001619Business: ROYAL MART SHELL Store #:
1113 E NINE MILE RD Phone: (804)737-5688Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23075 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NG1 LUEN176839-12 Diesel 12 0 Approved 0.000
Billing Address:
,
Notes:
Page 431 of 466
Inspector Acknowledged Receipt: BIJU KANAMKOMBIL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 2/14/2012 Business ID: 00111753 Inspection: AU001620Business: ZOTAS # 659 CITGO Store #: #659
501 S AIRPORT RD Phone: (804)328-5170Inspector: 325 MIKE TILLMAN
SANDSTON, VA 23150 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
02/14/12 03:16 PM 04:06 PM 0:50 0:00 0:50 C-97 BRAND LABELS ON GRADESTotal: 0:50 0:00 0:50
Class Actv App Rej Con CwC NTLiquid Measuring Device 16 16
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO N/A 5190-3 87 3 0 Rejected 0.000GILBARCO N/A 57296-1 87 1 0 Rejected 0.000GILBARCO N/A 57296-1 89 1 0 Rejected 0.000GILBARCO N/A 57296-1 93 1 0 Rejected 0.000GILBARCO N/A 57296-2 87 2 0 Rejected 0.000GILBARCO N/A 5190-3 89 3 0 Rejected 0.000GILBARCO N/A 5190-3 93 3 0 Rejected 0.000GILBARCO N/A 5190-4 89 4 0 Rejected 0.000GILBARCO N/A 5188-5 87 5 0 Rejected 0.000GILBARCO N/A 5188-6 87 6 0 Rejected 0.000GILBARCO N/A 5188-6 89 6 0 Rejected 0.000GILBARCO N/A 5188-6 93 6 0 Rejected 0.000GILBARCO N/A 5189-7 87 7 0 Rejected 0.000GILBARCO N/A 5189-7 93 7 0 Rejected 0.000
Page 432 of 466
Inspector Acknowledged Receipt: AHLAM NASSEREDDINE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO N/A 5189-8 87 8 0 Rejected 0.000GILBARCO N/A 5189-8 93 8 0 Rejected 0.000
Billing Address:
,
Notes:
MISSING BRAND LABELING ON GRADES NEEDS TO BE REPLACED
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
Page 433 of 466
Inspector Acknowledged Receipt: AHLAM NASSEREDDINE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 434 of 466
Inspector Acknowledged Receipt: AHLAM NASSEREDDINE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 2/15/2012 Business ID: 00161644 Inspection: AU001621Business: UPPYS# 27 Store #: #27
8601 PATTERSON AVE Phone: 804-864-5379Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23229 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 38 38Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 AAEN241197-A 87 1 0 Approved 5.000 GILBARCO NN1 AAEN241197-A 89 1 0 Approved 5.000 GILBARCO NN1 AAEN241197-A 93 1 0 Approved 5.000 GILBARCO NN1 AAEN241197-B 87 2 0 Approved 5.000 GILBARCO NN1 AAEN241197-B 89 2 0 Approved 5.000 GILBARCO NN1 AAEN241197-B 93 2 0 Approved 5.000 GILBARCO NN1 AAEN241195-A 87 3 0 Approved 5.000 GILBARCO NN1 AAEN241195-A 89 3 0 Approved 5.000 GILBARCO NN1 AAEN241195-A 93 3 0 Approved 5.000 GILBARCO NN1 AAEN241195-B 87 4 0 Approved 5.000 GILBARCO NN1 AAEN241195-B 89 4 0 Approved 5.000 GILBARCO NN1 AAEN241195-B 93 4 0 Approved 5.000 GILBARCO NN1 AAEN242296-A 87 5 0 Approved 5.000 GILBARCO NN1 AAEN242296-A 89 5 0 Approved 5.000 GILBARCO NN1 AAEN242296-A 93 5 0 Approved 5.000 GILBARCO NN1 AAEN241196-B 87 6 0 Approved 5.000 GILBARCO NN1 AAEN241196-B 89 6 0 Approved 5.000 GILBARCO NN1 AAEN241196-B 93 6 0 Approved 5.000 GILBARCO NN1 AAEN241199-A 87 9 0 Approved 5.000 GILBARCO NN1 AAEN241199-A 89 9 0 Approved 5.000
Page 435 of 466
Inspector Acknowledged Receipt: ALISON HOWARD
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 AAEN241199-A 93 9 0 Approved 5.000 GILBARCO NN1 AAEN241199-B 87 10 0 Approved 5.000 GILBARCO NN1 AAEN241199-B 89 10 0 Approved 5.000 GILBARCO NN1 AAEN241199-B 93 10 0 Approved 5.000 GILBARCO NN1 AAEN241198-A 87 11 0 Approved 5.000 GILBARCO NN1 AAEN241198-A 89 11 0 Approved 5.000 GILBARCO NN1 AAEN241198-A 93 11 0 Approved 5.000 GILBARCO NN1 AAEN241198-B 87 12 0 Approved 5.000 GILBARCO NN1 AAEN241198-B 89 12 0 Approved 5.000 GILBARCO NN1 AAEN241198-B 93 12 0 Approved 5.000 GILBARCO NL1 AAEN1200-A 87 11 0 Approved 5.000 GILBARCO NL1 AAEN1200-A 89 11 0 Approved 5.000 GILBARCO NL1 AAEN1200-A 93 11 0 Approved 5.000 GILBARCO NL1 AAEN1200-A Diesel 11 0 Approved 5.000 GILBARCO NL1 AAEN1200-B 87 12 0 Approved 5.000 GILBARCO NL1 AAEN1200-B 89 12 0 Approved 5.000 GILBARCO NL1 AAEN1200-B 93 12 0 Approved 5.000 GILBARCO NL1 AAEN1200-B Diesel 12 0 Approved 5.000
Device Product Used: 190. Insp Product Used: . Tot Product Used: 190.Grade Prod Used87 60.0089 60.0093 60.00Diesel 10.00
Billing Address:
,
Notes:
Page 436 of 466
Inspector Acknowledged Receipt: ALISON HOWARD
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 2/16/2012 Business ID: 00163441 Inspection: AU001624Business: J P MARKET Store #:
6103 E NINE MILE RD Phone: (804)737-3118Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 12 12
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE B12/3223D1/JK 99403A-3 87 3 0 Approved 0.000WAYNE B12/3223D1/JK 99403A-3 89 3 0 Approved 0.000WAYNE B12/3223D1/JK 99403A-3 93 3 0 Approved 0.000WAYNE B12/3223D1/JK 99404A-6 87 6 0 Approved 0.000WAYNE B12/3223D1/JK 99404A-6 89 6 0 Approved 0.000WAYNE B12/3223D1/JK 99404A-6 93 6 0 Approved 0.000WAYNE B12/3223D1/JK 99405A-7 87 7 0 Approved 0.000WAYNE B12/3223D1/JK 99405A-7 89 7 0 Approved 0.000WAYNE B12/3223D1/JK 99405A-7 93 7 0 Approved 0.000WAYNE B12/3223D1/JK 99405A-8 87 8 0 Approved 0.000WAYNE B12/3223D1/JK 99405A-8 89 8 0 Approved 0.000WAYNE B12/3223D1/JK 99405A-8 93 8 0 Approved 0.000
Billing Address:
,
Notes:
Page 437 of 466
Inspector Acknowledged Receipt: SATINDER SINGH
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 2/16/2012 Business ID: 00022159 Inspection: AU001625Business: DANCO MINI MART Store #:
3301 WILLIAMSBURG RD Phone: (804)222-0102Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 8 7 1Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
BENNETT 4024 48106801-11 Diesel 11 0 Approved 5.000BENNETT 4013 R7132 -12 Off Road Diesel 12 0 Approved 5.000 GILBARCO B7 PA122813-B 93 2 0 Approved 5.000 GILBARCO B7 PA127820-A 87 5 0 Approved 5.000 GILBARCO B7 PA127820-A 89 5 0 Approved 5.000 GILBARCO B7 PA127820-B 87 6 0 Approved 5.000 GILBARCO B7 PA127820-B 89 6 0 Approved 5.000WAYNE 51135 0169 Racing 7W 20 Condemned 5.000
Device Product Used: 40. Insp Product Used: . Tot Product Used: 40.Grade Prod Used87 10.0089 10.0093 5.00Diesel 5.00Off Road Dies 5.00Racing 5.00
Billing Address:
Page 438 of 466
Inspector Acknowledged Receipt: JESSE DISSE JR.
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
,
Notes:
BRAND REGISTRATION ON ALL GRADES
RACING FUEL NEEDS TO BE LABELED NOT FOR STREET USE
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104
Page 439 of 466
Inspector Acknowledged Receipt: JESSE DISSE JR.
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 440 of 466
Inspector Acknowledged Receipt: JESSE DISSE JR.
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 2/16/2012 Business ID: 00162015 Inspection: AU001627Business: E & C SHELL CORNER MART Store #: #14
2707 WILLIAMSBURG RD Phone: (804)222-4486Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231-2032 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 5 5
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NG0 EN020455-5 93 5 0 Approved 5.000GILBARCO NG0 EN020455-6 93 6 0 Approved 5.000GILBARCO NG0 EN020453-8 87 8 0 Approved 0.000GILBARCO NG0 EN020453-8 89 8 0 Approved 0.000GILBARCO NG0 EN020453-8 93 8 0 Approved 0.000
Device Product Used: 10. Insp Product Used: . Tot Product Used: 10.Grade Prod Used93 10.00
Billing Address:
,
Notes:
Page 441 of 466
Inspector Acknowledged Receipt: DEBORAH MCDANIEL
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 2/21/2012 Business ID: 00163059 Inspection: AU001634Business: QUARLES WATCHCARD Store #:
8410 BROOK RD Phone: -877-444-3835Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 10 10Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GASBOY 9153AXTW1C 460840 87 8 0 Approved 10.000GASBOY 9153AXTW1C 460850 87 1 0 Approved 5.000GASBOY 9153AXTW1C 460850 87 2 0 Approved 5.000GASBOY 9153AXTW1C 450839 Off Road Diesel 3 0 Approved 5.000GASBOY 9152ATXW1 C 460843 93 4 0 Approved 10.000GASBOY 9153ATW1-CX 460843 93 5 0 Approved 10.000GASBOY 9153ATW1-CX 460851 89 6 0 Approved 5.000GASBOY 9153ATW1-CX 469846 87 7 0 Approved 10.000GASBOY 9153AXTW1C 460840 Diesel 9 0 Approved 5.000GASBOY 9153AXTW1C 460841 Diesel 10 0 Approved 5.000
Device Product Used: 70. Insp Product Used: . Tot Product Used: 70.Grade Prod Used87 30.0089 5.0093 20.00Diesel 10.00Off Road Dies 5.00
Page 442 of 466
Inspector Acknowledged Receipt: ROBERT SWATS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Billing Address:
,
Notes:
Page 443 of 466
Inspector Acknowledged Receipt: ROBERT SWATS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 2/21/2012 Business ID: 00113863 Inspection: AU001636Business: SAM'S CLUB Store #: #6343
9440 W BROAD ST Phone: 804-346-3031Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23294 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 6 5 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 3/D595D/G/D 44659-3 87 3 0 Approved 5.000WAYNE 3/D595D/G/D 44659-4 87 4 11 Rejected 5.000WAYNE 3/D595D/G/D 44662-6 87 6 0 Approved 5.000WAYNE 3/D595D/G/D 44660-9 93 9 0 Approved 5.000WAYNE 3/D595D/G/D 44656-11 87 11 0 Approved 5.000WAYNE 3/D595D/G/D 44656-12 87 12 0 Approved 5.000
Device Product Used: 30. Insp Product Used: . Tot Product Used: 30.Grade Prod Used87 25.0093 5.00
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 444 of 466
Inspector Acknowledged Receipt: SCOTT WILLIAMS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 445 of 466
Inspector Acknowledged Receipt: SCOTT WILLIAMS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 2/21/2012 Business ID: 00110353 Inspection: AU001637Business: WILLOW LAWN SERVICE CENTER Store #:
5312 W BROAD ST Phone: (804)288-9341Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23230 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 20 20
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA208030-1 87 1 0 Approved 0.000GILBARCO B79 PA208030-2 87 2 0 Approved 0.000GILBARCO B79 PA208029-3 87 3 0 Approved 0.000GILBARCO B79 PA208029-4 87 4 0 Approved 0.000GILBARCO B7C PA208031-5 87 5 0 Approved 0.000GILBARCO B7C PA208031-6 87 6 0 Approved 0.000GILBARCO 1549100280 AV19237-7 87 7 0 Approved 0.000GILBARCO B79 PA208030-1 89 1 0 Approved 0.000GILBARCO B79 PA208030-2 89 2 0 Approved 0.000GILBARCO B79 PA208029-3 89 3 0 Approved 0.000GILBARCO B79 PA208029-4 89 4 0 Approved 0.000GILBARCO B7C PA208031-5 89 5 0 Approved 0.000GILBARCO B7C PA208031-6 89 6 0 Approved 0.000GILBARCO B79 PA208030-1 93 1 0 Approved 0.000GILBARCO B79 PA208030-2 93 2 0 Approved 0.000GILBARCO B79 PA208029-3 93 3 0 Approved 0.000GILBARCO B79 PA208029-4 93 4 0 Approved 0.000GILBARCO B7C PA208031-5 93 5 0 Approved 0.000GILBARCO B7C PA208031-6 93 6 0 Approved 0.000GILBARCO B7C PA208031-5 Diesel 5 0 Approved 0.000
Page 446 of 466
Inspector Acknowledged Receipt: P MANCHAS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Billing Address:
,
Notes:
Page 447 of 466
Inspector Acknowledged Receipt: P MANCHAS
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 2/21/2012 Business ID: 00021473 Inspection: AU001638Business: FAST STOP 1 Store #:
2301 MECHANICSVILLE TNPK Phone: (804)782-9326Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23223 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B05 PA037479-8 87 8 0Condemned w/Control
0.000
Billing Address:
,
Notes:
METER JUMP AT STARTUP OUT OF SERVICE UNDER INSPECTORS CONTROL NOT TO BE PUT BACK IN SERVICE UNTIL CHECKED BY INSPECTOR.
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
Page 448 of 466
Inspector Acknowledged Receipt: BASHAR MUSTAFA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 449 of 466
Inspector Acknowledged Receipt: BASHAR MUSTAFA
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/1/2012 Business ID: 00112832 Inspection: AU001656Business: 60 MART Store #:
3109 WILLIAMSBURG RD Phone: (804)226-1059Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
03/01/12 09:03 AM 09:28 AM 0:25 0:00 0:25 leaking hoseTotal: 0:25 0:00 0:25
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NP3 FREN094808-9 Diesel 9 0 Condemned 0.000
Billing Address:
,
Notes:
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 450 of 466
Inspector Acknowledged Receipt: akash patel\
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 451 of 466
Inspector Acknowledged Receipt: akash patel\
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/1/2012 Business ID: 00022159 Inspection: AU001657Business: DANCO MINI MART Store #:
3301 WILLIAMSBURG RD Phone: (804)222-0102Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23231 Reason: Reinspection 2
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
WAYNE 51135 0169 Racing 7W 0 Approved 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod UsedRacing 5.00
Billing Address:
,
Notes:
Page 452 of 466
Inspector Acknowledged Receipt: JESSE L DISSE JR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/1/2012 Business ID: 00111753 Inspection: AU001658Business: ZOTAS # 659 CITGO Store #: #659
501 S AIRPORT RD Phone: (804)328-5170Inspector: 325 MIKE TILLMAN
SANDSTON, VA 23150 Reason: Reinspection 1
Class Actv App Rej Con CwC NTLiquid Measuring Device 16 16
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO N/A 5190-3 87 3 0 Approved 0.000GILBARCO N/A 57296-1 87 1 0 Approved 0.000GILBARCO N/A 57296-1 89 1 0 Approved 0.000GILBARCO N/A 57296-1 93 1 0 Approved 0.000GILBARCO N/A 57296-2 87 2 0 Approved 0.000GILBARCO N/A 5190-3 89 3 0 Approved 0.000GILBARCO N/A 5190-3 93 3 0 Approved 0.000GILBARCO N/A 5190-4 89 4 0 Approved 0.000GILBARCO N/A 5188-5 87 5 0 Approved 0.000GILBARCO N/A 5188-6 87 6 0 Approved 0.000GILBARCO N/A 5188-6 89 6 0 Approved 0.000GILBARCO N/A 5188-6 93 6 0 Approved 0.000GILBARCO N/A 5189-7 87 7 0 Approved 0.000GILBARCO N/A 5189-7 93 7 0 Approved 0.000GILBARCO N/A 5189-8 87 8 0 Approved 0.000GILBARCO N/A 5189-8 93 8 0 Approved 0.000
Billing Address:
Page 453 of 466
Inspector Acknowledged Receipt: JEEVAN NAHAR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
,
Notes:
Page 454 of 466
Inspector Acknowledged Receipt: JEEVAN NAHAR
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 3/2/2012 Business ID: 00110869 Inspection: AU001662Business: WAWA Store #: #682
8851 STAPLES MILL RD Phone: 804-262-7335Inspector: 325 MIKE TILLMAN
RICHMOND, VA 23228 Reason: Routine
Class Actv App Rej Con CwC NTLiquid Measuring Device 48 48Gas Station 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA230477-10 89 10 3 Approved 5.000GILBARCO B79 PA230481-1 87 1 0 Approved 5.000GILBARCO B79 PA230477-10 93 10 0 Approved 5.000GILBARCO B79 PA230481-1 89 1 0 Approved 5.000GILBARCO B79 PA230474-12 89 12 0 Approved 5.000GILBARCO B79 PA230481-1 93 1 4 Approved 5.000GILBARCO B79 PA230481-2 87 2 0 Approved 5.000GILBARCO B79 PA230481-2 89 2 0 Approved 5.000GILBARCO B79 PA230481-2 93 2 0 Approved 5.000GILBARCO B79 PA230479-3 87 3 0 Approved 5.000GILBARCO B79 PA230479-3 89 3 0 Approved 5.000GILBARCO B79 PA230479-3 93 3 0 Approved 5.000GILBARCO B79 PA230479-4 87 4 1 Approved 5.000GILBARCO B79 PA230479-4 89 4 1 Approved 5.000GILBARCO B79 PA230479-4 93 4 1 Approved 5.000GILBARCO B79 PA230476-5 87 5 2 Approved 5.000GILBARCO B79 PA230476-5 89 5 2 Approved 5.000GILBARCO B79 PA230476-5 93 5 2 Approved 5.000GILBARCO B79 PA230476-6 87 6 0 Approved 5.000GILBARCO B79 PA230476-6 89 6 1 Approved 5.000
Page 455 of 466
Inspector Acknowledged Receipt: GARY FIELD
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B79 PA230476-6 93 6 0 Approved 5.000GILBARCO B79 PA230475-7 87 7 1 Approved 5.000GILBARCO B79 PA230475-7 89 7 1 Approved 5.000GILBARCO B79 PA230475-7 93 7 1 Approved 5.000GILBARCO B79 PA230475-8 87 8 0 Approved 5.000GILBARCO B79 PA230475-8 89 8 0 Approved 5.000GILBARCO B79 PA230475-8 93 8 -1 Approved 5.000GILBARCO B79 PA230477-9 87 9 2 Approved 5.000GILBARCO B79 PA230477-9 89 9 2 Approved 5.000GILBARCO B79 PA230477-9 93 9 1 Approved 5.000GILBARCO B79 PA230477-10 87 10 3 Approved 5.000GILBARCO B79 PA230474-11 87 11 2 Approved 5.000GILBARCO B79 PA230474-11 89 11 3 Approved 5.000GILBARCO B79 PA230474-11 93 11 2 Approved 5.000GILBARCO B79 PA230474-12 87 12 2 Approved 5.000GILBARCO B79 PA230474-12 93 12 0 Approved 5.000GILBARCO B79 PA230478-13 87 13 0 Approved 5.000GILBARCO B79 PA230478-13 89 13 0 Approved 5.000GILBARCO B79 PA230478-13 93 13 0 Approved 5.000GILBARCO B79 PA230478-14 87 14 0 Approved 5.000GILBARCO B79 PA230478-14 89 14 2 Approved 5.000GILBARCO B79 PA230478-14 93 14 1 Approved 5.000GILBARCO B79 PA230480-15 87 15 1 Approved 5.000GILBARCO B79 PA230480-15 89 15 0 Approved 5.000GILBARCO B79 PA230480-15 93 15 2 Approved 5.000GILBARCO B79 PA230480-16 87 16 2 Approved 5.000GILBARCO B79 PA230480-16 89 16 2 Approved 5.000GILBARCO B79 PA230480-16 93 16 4 Approved 5.000
Device Product Used: 240. Insp Product Used: . Tot Product Used: 240.Grade Prod Used87 80.0089 80.0093 80.00
Page 456 of 466
Inspector Acknowledged Receipt: GARY FIELD
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Billing Address:
,
Notes:
Page 457 of 466
Inspector Acknowledged Receipt: GARY FIELD
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 5/27/2011 Business ID: 00161691 Inspection: BA001101Business: UPPY S EXXON Store #: #36
8208 W BROAD ST Phone: 804-965-9082Inspector: 018 BRIAN CROWDER
RICHMOND, VA 23229 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
05/27/11 12:39 PM 01:40 PM 1:01 0:00 1:01 C-8769Total: 1:01 0:00 1:01
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B05 PA048021-11 87 11 4 Approved 10.000
Device Product Used: 10. Insp Product Used: . Tot Product Used: 10.Grade Prod Used87 10.00
Billing Address:
,
Notes:
CALLED CUSTOMER AND LEFT MESSAGE, TESTED PUMP #11 REG 87 FAST TEST SHOWED 4CU.IN AND SLOW TEST ALSO SHOWED 4CU.IN. i
Page 458 of 466
Inspector Acknowledged Receipt: PRESTON GAINER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
DETERMINED THAT THE PUMP WAS ACCURATE AND CORRECT NO ACTION TAKEN.
Page 459 of 466
Inspector Acknowledged Receipt: PRESTON GAINER
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 7/8/2011 Business ID: 00163583 Inspection: BA001169Business: NORTH PARK SHELL Store #: #10
805 PARHAM RD Phone: 804-266-4407Inspector: 018 BRIAN CROWDER
RICHM0ND, VA 23227 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
07/08/11 01:00 PM 02:00 PM 1:00 0:00 1:00Total: 1:00 0:00 1:00
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B78 PA141848-12 87 12 0 Condemned 0.000
Billing Address:
,
Notes:
PUMP JUMPED AT BEGINING OF SALE ANTIDRAIN MEANS NOT EFFECTICE, PUMP 12 87 CONDEMED FOR REPAIRS. CUSTOMER HAS BEEN CONTACTED BEFORE AND AFTER TESTING.
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 460 of 466
Inspector Acknowledged Receipt: KUMAR BURRE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 461 of 466
Inspector Acknowledged Receipt: KUMAR BURRE
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/28/2011 Business ID: 00500737 Inspection: BA001449Business: UPPYS # 28 Store #: #28
3101 LAUDERDALE DR Phone: 804-360-0269Inspector: 018 BRIAN CROWDER
RICHMOND, VA 23233 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
12/28/11 02:30 PM 03:30 PM 1:00 0:00 1:00 C-Total: 1:00 0:00 1:00
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO NN1 GSEN130310-6 87 6 0 Condemned 5.000
Device Product Used: 5. Insp Product Used: . Tot Product Used: 5.Grade Prod Used87 5.00
Billing Address:
,
Notes:
TESTED PUMP # 6 87 FOUND METER CONTINUED TO RUN AFTER NOZZLE TRIGGER HAD BEEN RELEASED (METER CREEP). MANAGEMENT HAD
Page 462 of 466
Inspector Acknowledged Receipt: DAVID ADDINGTON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
PLACED AN OUT OF ORDER BAG ON NOZZLE BEFORE I ARRIVED TO TEST. CONDEMED UNTIL REPAIRS HAVE BEEN MADE.
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1
Page 463 of 466
Inspector Acknowledged Receipt: DAVID ADDINGTON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 464 of 466
Inspector Acknowledged Receipt: DAVID ADDINGTON
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
Insp Date: 12/30/2011 Business ID: 00113669 Inspection: BA001454Business: FAS MART Store #: #78
5600 LAKESIDE AVE Phone: (804)264-5614Inspector: 018 BRIAN CROWDER
RICHMOND, VA 23228 Reason: Complaint
Time In / Time OutDate In Out Insp Travel Total Notes
12/30/11 01:00 PM 02:22 PM 1:22 0:00 1:22Total: 1:22 0:00 1:22
Class Actv App Rej Con CwC NTLiquid Measuring Device 1 1
Make Model Serial # Location OtherMaxErr
Results Prod Used Notes
GILBARCO B65 PA047265-2 93 2 0 Condemned 0.000
Billing Address:
,
Notes:
CALLED CUSTOMER LEFT MESSAGE , TESTED FIVE GAL ON PUMP 2,93 HAD PUMP JUMP AT BEGINNING OF TEST. CONDEMED 93 HOSE UNTIL REPAIRS CAN BE MADE.
REJECTED DEVICES: Devices indicated as "Rejected" must be repaired within ten (10) days of issuance of this inspection notice.
Page 465 of 466
Inspector Acknowledged Receipt: CARMEN RODRIGUEZ
Device Inspection Grid Summary
Filter: Type = Liquid Measuring Device and Business County = Henrico (087) and Inspection Date > 03/01/2010
CONDEMNED DEVICES: Devices indicated as "Condemned" must not be used until repaired or replaced.
CONDEMNED DEVICES SUBJECT TO CONTROL OF REJECTING AUTHORITY: Devices indicated as "Condemned w/Control" are to remain out of service until official reinspection and approval by VDACS-OWM.
NOTICE TO SERVICE AGENCIES AND TECHNICIANSService Report: Every service agency shall furnish each service technician in its employment with a supply of report forms entitled "Placed into Service" prescribed by the Commissioner. Within five (5) business days after its service technician has placed in or restored to service a weight or measure, the service agency shall provide to the Commissioner a fully executed Placed into Service Report.
Where to Forward this Notice and Service Report:This notice to Weights and Measures Service Agencies and Technicians along with the Placed into Service Report for the above referenced business must be mailed or faxed to the office location initialed below. (1 of 4, see additional page if applicable)
______VDACS-OWM, 102 Governor St., Richmond, VA 23219 Fax: (804) 786-1571______VDACS-OWM, 1100 Armory Drive, Apt. 120, Franklin, VA 23815 Fax: (757) 562-6104______VDACS-OWM, 261 Mt. Clinton Pike, Harrisonburg, VA 22802 Fax: (540) 432-1357______VDACS-OWM, 250 Cassell Road, Wytheville, VA 24382 Fax: (276) 228-6579
Penalty for Failure to Comply with this Notice: §3.2-5713. PenaltiesA. Any person violating any provision of the Weights and Measures Service Agencies and Technicians Law is guilty of a Class 1 misdemeanor, and may, in addition to or in lieu thereof, be assessed a civil penalty, as provided in §3.2-5714.
Technician Signature: ___________________________________ Permit Number: __________ Date: ______________
Page 466 of 466
Inspector Acknowledged Receipt: CARMEN RODRIGUEZ