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OCT -03-2007 08:32 AM GETTLER-RYAN INC. 925 551 4770 MONITORIN,, SYSTEM CERTIFICATION ,rPIO Whoritt•C'ited4C'hupter 6.7. FI a/th trod , %phu('nJr"(7tap cry/(, in �/)iti tvnn ? (%� )t/r�_'3/('crlllnrnia ('ode of kegulullans lltis form must he used to document testing and servicing of monitoring equipment. �\.Mpllid►e r�cr 'gip inn r�r�r p �u tiLr gch rngpitorin ate rL 1 pAqe1 by the technician who perf0rrns the work. A copy of this form must be provided to the tank system owner/operator. 'fftc owner/operator must submit a cop) of this form to the local gentry regulating LIST svatems within 30 days ot'tcst date„ A. General Information I•acility Namo: ARCO _ _ E41dg, No.: Site Addrrag: _3212 N CALIFORNIA__-- ___ C HY STOCKTON- _- 7.ip: llacilitp Contact Person: _ ^_. .._ Contact Phone No.; Make/Model of Monitoring System: JIS 351► _. Date of"I'csting/Servicing. _04/_19 /_07.• B. Inventory of Equipment Tested/Certifled P. 02 DtNlst�d• DNatada tf tMne than one monitoring system cuatrd panel in metalled ai the Deist dt In an? I printed on tha bac* of this i. Pa6r•1 Ila— R W mens Tank ID '1'1 T'NI.F.ADFD RFGLII AR MARTER 'T'ank ID —� i' D�lebth a In -Tank Gnuging Proba. Model: - ,_-_•- _-_-, .•_•• ,-- G in -1 GauginK f robe. Madel: 0 Annular Spaceor Vault Sensor, Model: _ _ _ - ❑Annular Space or Vault Sensor. Model: Pipmg Sump 11'reneh 5cnsar(s), Madel', 796TN&3 U ♦ iping Suirip /'french Senwgsy Model: - - -- - - J Fill Swap Serisar(a), Mtx1aL' _ V pill Sump Sanstrr(s), Model: _ U Mechanical line Leak fetector. Model: _ _ Cl 0 Mechanical I,inc Leak Detector Model: F.ltvahmic Line leak Detector. Model:_ • ...__.. ❑ 'Tank _. .- U FlcctrctriiC Line beak Detector. Model; Overfill / I ligh•Level Sensor. Model; _ U fAhcr ,.,_,. ,. __• •,•� - __. Q 'tank Overfill / I ligh-Levet Sensor. Model: s cv ui ntent tvpa and model in Section E on 112att 2). ❑ Other (spccif.v e ui tm,nt ry�tc and model in Section E on Page 2 - Tank II)t U In=yank Gauging Probe. Model:.. Tank ID: _.._...._ . _� f..1 In- took Gauging Prole. Model Annular Sparc or Vault Sensor. Mcxka: _ - ❑Annular Spore or Vault Sensor. Madel, Piping Stith . p Trench Ss.nsor(s). Model: •_. J pill Sump Sensor(s). _-.- J piping Sump /Trench 1enstrr(5) Model' , model:.,_ ..._._..... ,.... �] Mechanical Linc Leak Detector Model: - _ J fill Sump Sensor(s). Mtulcf ❑ Mechanical Line I.eWe Iklt�clor. Model: J Electronic Line Leak Detector. Model: _ J '!'ark t7vetiill / I ligh.l.cvcl Sensor. Model: T' — --' U FIcaronic Line leak Detector. Model: - LI Tank Ovcrf(II / I ligh•l.ovul Sensor. Model: ❑ Other igficci6 N ul merit type and ttttxlcl to Section IT, on Ire a _! ❑ Others i' cquiLatimt type and model in Seetltm fi Dispenser 11); Dispenwr ID: J lhspenserC'onlairamn Sensot(s). Model'—M--. _. ___.....__._ .._.... U UispcnserCnntainrocnt Sensor(,.,). Mtrdcl: U Shear Vulve(s). _.—....,_.. L1Shear Valve(,). .___-•- ❑ Dis. enscr Containment I'loalls and Chain(s). U Dispenser nser Containment fluat(S) at d Chai s Dispenser 11):.-„- . _— _-- --- --- U Ihspenver Containment 9ensogs). Model: • Dispenser ID: r. U l)IS)knscr Contatnmenl Scnsurtsi. model; ••...,,• (3 Shear Valva(s). ❑ Shear Valvc(s). _.._._. ....-- U Dis nscr('ontainment Ploal(s) and Chains), U Ids enter Containment Flnat sf and Chain(s). , _. _ .del ;_. V Dispenser Contatrurhtnl Sensor(s), Mo hsN.eiserCo Dicer icrCtsit in'rtxnlSeMKtrts). Mock- - U 1. - ❑ - -_ ts nscr Containment Flaast) and Chain(s).� I ❑Dispenser Containmcnt HMO) and C.hairw. "If the I'Mility contains mate tanks ordispensers, copy this form. Include information far every tank and dispenser at the facility. C. CertiflCadOn . I cc” that the equipment klentliled In this document wax Inspected/wrvleed In accordance the with natnutpeturets' guidelines, Attkehad to this CeMilleatkm is informution (e.g. manufaehsrers' checkiisn) necessary to verily that this ImlhrtlWNoh is _.... .. I irorreet and a4yR PLen .howl. S the layout of mooltoring equipment. For any egpipment capable of genentltng such report., I have 060 O�ht�d ytsr attaetted a copy of the repterq (check all shot aWy); Technician Natne (print): NYSTROM..—_._ U System set-up ❑ Alart history re t ��_ � � I{ —NARK j (-rnticanon *lu.. _835608 „_.--- .Signature: �-! _ Dstated, CL•.i.Ajc. vc, .__... ....-. Testing Company Name: G T'I'LER RYAN 1 (' Phone Noj 925.__x._5514777 ,SdeAddress: / ��_ oateoflcsting/Servi�rng: 09 /19 07 amort Monitoring System Certifleatlnn Page 1 o1`3 p�ipq