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MONITC*ING SYSTEM CERTIFfATION <br /> CERTIFICATION 1 TEST DATE: Septemeber 2, 2011 <br /> Al. FACILITY A2. OWNER <br /> Name 7-Eleven Market#2368!Store#14117 Name 7-Pleven, Inc <br /> Address 2725 Country Club Lane,Stockton,CA 95201 Address P.O.Box 711,Dallas,TX 75221 <br /> Phone# 209-463-1259 Phone# 805-523-2949 <br /> Contact Stephen Boyd Contact Stephen Boyd <br /> D. RESULTS OF TESTING !SERVICING <br /> Make 1 Model of Monitoring System: Veeder-Root TLS-350 <br /> Software Version Installed: 331.01 <br /> Complete the following checklist: <br /> - <br /> ■ Yes ❑ No* Is the audible alarm operational? <br /> N Yes ❑ No* Is the visual alarm operational? <br /> ■ Yes ❑ No* Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> ■ Yes ❑ No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment <br /> will not interfere with their proper operation? <br /> Yes ❑ No* If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modems) <br /> ❑ NIA operational? <br /> Yes IN o* For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment <br /> NIA monitoring system detects a leak,fails to operate,or is electrically disconnected? If yese which sensors initiatepositive shutdown? (check all that apply) ■ Sumpfrrench sensors; ■ Dispenser Containment.Sensors. <br /> Yes No* Did you confirm positive shut-down due to leaks and sensor failureldisconnectlan? <br /> F-1_-Yes [INo* For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.no <br /> ■ NIA mechanical overfill prevention valve is installed),is the overfill warning alarm visible and audible at the tank <br /> fill point(s)and operating properly? If so,at what percent of tank capacity does the alarm trigger? % <br /> ❑ Yes* ■ No Was any monitoring equipment replaced? If yes,Identify specific sensors,probes,or other equipment replaced <br /> and list the manufacturer name and model for all replacement parts in Section E,below. <br /> ❑ Yes* ■ No Was any liquid found inside any secondary containment systems designed as dry systems? <br /> (Check all that apply) El Product; El Water. If yes,describe causes in Section E,below. <br /> N Yes ❑ No* Was monitoring system set-up reviewed to insure proper settings? Attach set-up reports,If applicable, <br /> Yes ❑ No* Is all monitoring equipment operational per manufacturer's specifications? <br /> * In Section E below, describe how and when these deficiencies were or will be corrected. <br /> E. COMMENTS <br /> This is a MSC test after cold start. — - <br /> '7M 1 Walton Engineering,Inc. <br /> Page 2 of 3 <br />