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Jun 22 03 05: 32p M*Dotten 2093-2650 P. 1 <br /> Alit` c k <br /> 17759 Buttercup Circle, Sonora, CA 95370 <br /> Phone: 209-532-7320; Fax: 249-533-2650 <br /> California Contractor 623541 A-I-laz <br /> alitech@getrocket.com <br /> MONITORING SYSTEM CERTIFICATION <br /> A- Gene nfort on <br /> Faciti arae: Linden Associated Growers Date ofTes g/3ervicing:June 18,2003 <br /> Face ty Address: 14175 E.Hwy 26,Linden CA 4532+6 <br /> Fa lity Contact Person: Charlie Busalacchi Contact P e No.:209-931-4800 <br /> Ma e/Model of Monitoring System: Veeder- S-250 <br /> B. I to of Equiested/Certified: _ <br /> Tank TD:Gasoline Compartment Tank ID:Diesel Compartmant <br /> ❑In-Tank Gauging Probe, Model:None ❑In-Tank Gauging Probe. Model:None <br /> M Annular Space or Vault Sensor. Model:Float Switch Annular Space or Vault Sensor. Model:Shared with Gas side <br /> ❑Piping Sump/Trench Sensor(s). Model:None ❑Piping Sump 1 Trench Sensor(s). Model:None <br /> ❑Fill Sump Sensor(s). Model:None ❑Fil l Sump Sensor(s). Model:None <br /> ❑Mechanical Line Leak Detector. Model:None ❑Mechanical Line Leak Detector. Model:None <br /> ❑Electronic Line Lcak Detector. Model:None ❑Electronic Line Leak Detector. Model:None <br /> ®"tank Overfill/High-Level Sensor. Model:Drop Tube ®Tank Overfill l Iiigh-Levet Sensor. Model:Drop Tube <br /> ❑Other ❑Other <br /> Tank ID: Tank tD: <br /> ❑In-Tank Gauging Probe. Model: ❑In-Tank Gauging,Probe. Model: <br /> ❑Annular Space or Vault Sensor. Model: ❑Annular Space or Vault Sensor. Model: <br /> El Piping Sump/Trench Sensor(s). Model: []Piping Sump I Trench Sensor(s). Model: <br /> Fill Sump Sensor(s). Model: ❑Dill Sump Sensor(s). Model: <br /> ❑Mechanical Line Leak Detector. Model: ❑Mechanical Line Leak Detector. Model: <br /> ❑Electronic Line Leak Detector. Model; ❑Electronic Line Leak Detector. Model: <br /> ❑Tank Overfill/High-Level Sensor. Model: ❑Tank Overfill/High-Level Sensor. Model: <br /> El Other ❑Other <br /> Dispenser ID:Gas M Sump:❑Dry MWater MProduct Dispenser 10:Diesel M Sump:❑Dry 0Water MProduct <br /> M Dispenser Containment Sensor(s). Model:Float SW. ®Dispenser Containment Sensor(s). Model:Float Switch <br /> ❑Shear Valve(s) (Functional test) ❑Shear Valve(s) (Functional test) <br /> ❑Dispenser Containment Float(s)and Chain(s). ❑Dispenser Containment Float(s)and Chain (s). <br /> Dispenser ID: ❑ Sump:❑Dry❑Water❑Product Dispenser ID: ❑ Sump:❑Dry❑Water❑Product <br /> ❑Dispenser Containment Sensor(s). Model: ❑Dispenser Containment Sensor(s). Model: <br /> ❑Shear Valve(s) (Functional test) ❑Shear Valve(s) (Functional test) <br /> ❑Dis enser Containment Float s)and Chain (s). ❑Dispenser Containment Floats and Chain(s). <br /> Dispenser ID: ❑ Sump:[]Dry❑Water❑Product Dispenser ID: ❑ Sump:(]Dry[]Water❑Product <br /> ❑Dispenser Containment Sensor(s)_ Model: ❑Dispenser Containment Sensor(s). Madel: <br /> [:]Shear Valve(s) (Functional test) ❑Shear Valvc(s) (Functional test) <br /> 11 ❑Dispenser Containment Float(s)and Chains _ ❑Dispenser Containment Float(s)and Chain(s). <br /> C. Certification - I certify that the equipment identified in this document was inspected/serviced in accordance with the <br /> manufacturers' guidelines. Attached to this Certification is information (e.g.manufacturers'checklists) necessary to verify that this <br /> information is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such <br /> reports,I have also attached a copy of the report; (cheek all that apply): ❑System set-up ❑ Alarm history report <br /> Technician: � e� Mike Dotten,California Contractor License. No.:623541 <br /> Certification:Veeder-Root: 341-32-6743; Level 3. <br /> Page 1 of 3 03/01 <br />