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MONIT%31NG SYSTEM CERTHWATION CERTIFICATION 1 TEST DATE: January 8, 2009 Al. FACILITY A2. OWNER Name 7-Eleven Market#2368 I Store#14117 Name 7-Eleven, Inc Address 2725 Country Club Lane,Stockton,CA 95201 Address P.O. Box 711, Dallas,TX 75221 Phone# 209-463-1259 Phone# 805-523-2945 Contact Jay Stemley Contact Shane Partridge F. IN-TANK GAUGING I SIR EQUIPMENT: ❑ Check this box if tank gauging is used only for inventory control. ❑ Check this box if no tank gauging or SITZ equipment is installed. This section must be completed if in-tank gaugung equipment is used to perform leak detection monitoring. Complete the following checklist: ❑ Yes ❑ No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? ❑ Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? ❑ Yes ❑ No* Was accuracy of system product level readings tested? ❑ Yes ❑ No* Was accuracy of system water level readings tested? ❑ Yes ❑ No* Were all probes reinstalled properly? ❑ Yes 0 No* Were all items on the equipment manufacturer's maintenance checklist completed? * In Section H below, describe how and when these deficiencies were or will be corrected. G. LINE LEAK DETECTORS (LLD): ❑ Check this box if LLDs are not installed. Complete the following checklist: ❑ Yes ❑ No* For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance? ❑ NIA (check all that apply) Simulated leak rates ■ 3 g.p.h.; ❑ 0.1 g.p.h.; ❑ 0.2 g.p.h. ❑ Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? ❑ Yes ❑ No* Was the testing apparatus properly calibrated? ❑ Yes ❑ No* For mechanical LLDs,does the LLD restrict product flow if It detects a leak? ❑ NIA FEIYe ❑ No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? ❑ NIA ❑ No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled ❑ NIA or disconnected? El Yes El No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions ❑ NIA or falls a test? ❑ Yes ❑ No* For electronic LLDs,have all accessible wiring connections been visually inspected? ❑ NIA ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In Section H below, describe how and when these deficiencies were or will be corrected. H. COMMENTS This is a MSC modification test after ISD installation and cold start. C)2006 Walton Engineering,Inc. Page 3of3