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DEC-04-2008 02 :25 PM GETTLER—RYAN INC. 925 551 4770 P. 03 MONITORING SYSTEM CERTIFICATION For UseBy X111 Jurodirtion,v Within the 5'tale of California it uthority Cited: Chapter 6.7. Health and Safoi (brie; Chapter 16, Division 3, Titly:i. California Code of Regulations This form must be used to document testing and servicing of munitoring equipment. �, y@ur�lt, y;,oertifis:ntipn ur tirlt,LS,L? RL1Di't'�-1•QL )nnnitOujing systunn conlmi mine] by the technician who performs the work. A copy(it this tori must be providOd to the tank syrtem owncr/operator. The owner/operator must submit a copy of this form to the local ngcney regulming LIST sy+lent+within?U days of test date. A. General Information Facility Name: PG&E _ Bldg' No.'-,---"'----,-"_- Sice Address: Pers Wast Ln=. ----_.. -- _. C-rty: StocktonLlonc Nosed g9 e6 lip: 95204 2-7038 Facility Contact Person: Michelle La i--�---•—•--------- Make'Model ol'Momtoring System. TLS-350 icing: 11/2612008 _ B. Inventory of Equipment Tested/Certified Check the anarts,riart boxes to Indicate a reclfle equipment ins eded/serviced: Tank ID: Unleaded _ Tank ID _.Diesel ❑In-Tank Graging Probe. Model: _ ❑ In-Tank❑auging Probe, Model: _ ®Amiular Space or Vault Stuart, Mudd. 7043811-420 ® Annular Space nt Vault Sane'. Madd 794300.470 —� ®Piping Sump l Trench Scnsons) Madel: 794380.708 I3 Piping Sump Trench Senor,,). Model: 794380-208 ,_, ❑Fill Sump Semar(sl- Model: __. ❑ Fill Sump Semon,). Model: ❑Mechanical Line Leak Detector. Madel. ❑ Me'eMnicnl Line Leak Dctectnr. Modcl: - ®Electronic Line Leak Danctor. Model 848480.001 ��— fZ Glev_trnnn Line Leak Dutechtt Model: 848480-001 ❑Tank Ovenill High-LeveISuns<rr. Modef ❑Tank 0%enill High-level Sthtsar. Model: ❑OdW i spaify equipmonl type and model in Suction Eon Page 2i ❑Other(npceifv x{uipo an type and model in Section E on Page„I Tank ID: Waste oil _ Truk ID: ❑ In-Tank Causing Pmbe. Model ❑ In-Timk(iauging Probe. M(del. ®Annular Space or Vault Sensor, Model, 794390-420 ❑ Annular Space or vaull SC•nua, Modcl: ®Piping SumpTrencb Sersagsi. Model, 70439M208 ❑Pipinp.Sump Tremeh$e`nwips) Maki; ❑Fill Sump Sensory s). Madcl. []Fill Sump Seasonal. Model'. ❑Mechanical Line Leak Decl:lor Model: El Mechanical Linc Irak Dctmlor. Modell Z Cleetroniz Line Leak IX-tectorModel: 848480.1101 _ F1 ElCmn+nic Line Leak Detector. Model: , ❑Tank Overfill)High-Level Senhur. Model: ❑'lank Overfill Nigh-Level Scneta. Model'. ❑other(specify equipment type amt made]in Section E on Page 21 Otheti'(spceil'y sluipmrnl type and model in Section E on Page I). Dispenser ID: 112 Dispenser ID:_314 0Dispenser Commitment Season,), Mudd.. 794380-2118 Dispunser(viamnmctilScrimms) Model 794380.209, M Shear Valve(s). Shcar Vulvvlsl. ® Dispmsa Containment Flom(s)and Chuin(s). ❑ Dispenser Cuntainmcnt Flont(s)and Chmu(ny Dispenser ID: 516 Dispenser ID: 7/8 ®Dispenser Containmet[Sensnns). Model: 704300-208 Model Uispum.cr Camainmem Sanson s•). Model'. 794380-209 ®Shear Vaho(s). Sheat V:dvds). ®Dispenser Containment Floats)and Chemist. Dispenser Contuinment Mottos)and Chain(s). Dispenser ID: Dispenser ID: _ ❑ Dispenser Containmcml Seasons) Model: — _ ❑ Dispenser('onlainmmt Senwsgs). Model: _ ❑Shev Vaht(s). [.]Shcar Valvas). ❑Drspcnaer Comeinment Float(ar and Chain(s). ❑ Dispenser Containment Floats)and Chain(s). -If the facility contains more ranks or disprmsca's,copy this faun Include information for every, lank and diaperiWT tit the facility. C. Certification .I certify that the equipment identified In this document was inapected/serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this iarormanon is correct and a Plot Plan showing the layout of monitoring equipment. Far any eqmart ur capable of generating such reports,I have also attached a copy of the report;(chock all that apply); ® System set-up Alarm history report Technician Name]print): Christophe[Thornton„------ Signature:..---__- .._.�--...__......—..—_..._.— Certification No.: A31563 License No.: 220793 Testing Company Name• Gettler-Ryan Inc. Phone No _2551.4777 Tenting Company Address: 6747 Sierra Ct., Sta J,Dublin Ca _ date of I catingiServicing 1112512008 Page 1 of 3 Rev(2.09)