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MONITOVG SYSTEM CERTIFIC:TION CERTIFICATION / TEST DATE: February 17, 2010 At. FACILITY A2. OWNER Name Fast Lane Lathrop Name Christina Gill Address 116 E.Roth Road,Lathrop,CA 95330 Address 111 Healdsburg Avenue,Healdsburg,CA 95448 Phone# 707-431-0541 Phone# 707-431-0541 Contact Christina Gill Contact Christina Gill D. RESULTS OF TESTING 1 SERVICING Make / Model of Monitoring System: Veeder-Root TLS-350 Software Version Installed: 327.04 Complete the following checklist: _ ■ Yes ❑ No* Is the audible alarm o erational7 ■ Yes ❑ No* Is the visual alarm operational? ❑ Yes ❑ No* Were all sensors visually inspected,functionally tested,and confirmed operational? ❑ Yes ❑ No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? r-1Yes ❑ No* If alarms are relayed to a remote monitoring station,Is all communications equipment(e.g.modems) ❑ N/A operational? _ ❑ Yes ❑ No' For pressurized piping systems,does the turbine automatically shut down If the piping secondary containment ❑ NIA monitoring system detects a leak,fails to operate,or is electrically disconnected? If yes:which sensors initiate positive shutdown7 (check all that apply) ❑ SumPlTrench sensors; ❑ Dispenser Containment Sensors. ❑ Yes ❑ No* Did you confirm positive shut-down due to leaks and sensor failureldisconnection? ❑ Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.no ❑ N/A mechanical overfill prevention valve is installed),is the overfill warning alarm visible and audible at the tank fill point(s)and operating properly? If so,at what percent of tank capacity does the alarm trigger? % ❑ Yes* ■ No Was any monitoring equipment replaced? If yes,Identify specific sensors,probes,or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E,below. ❑ Yes* ❑ No Was any liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) ❑ Product; ❑ Water. If yes,describe causes in Section E,below. ■ Yes ElNo* Was monitoring system set-up reviewed to insure prpper settingsf applicable. ? Attach set-up reports,i ■ Yes ❑ No* Is all monitoring equipment operational per manufacturer's specifications? - In Section E below, describe how and when these deficiencies were or will be corrected. E. COMMENTS ©zoos Walton Engineedng,inc. Page 2 of 3