Laserfiche WebLink
t ' <br /> P.O.Bar.X1208 <br /> , Sancra CA 95379 <br /> Ca'.623541 A-Hv <br /> AfftechPetrd <br /> Phone:2C9-532-732.1Compliance Without Compromise Fax:2C9-533-2:,50 <br /> Md IraIF.Achprtrr..cnm <br /> n^raa;.alt�+chpMrc.cnm <br /> MONITORING SYSTEM CERTIFICATION <br /> A. General Information <br /> Facility Name: Arco#2186 Date of Testing/Servicing: February 14, 2012 <br /> Facility Address:3212 N. California St., Stockton CA 95204 <br /> Facility Contact Person: Facility Phone: 209-941-2694 <br /> LIA: San Joaquin County EHD;Inspector: ;LIA Phone: ; LIA Fax: <br /> Make/Model of Monitoring System: Veeder-Root TLS-350 LIA email; <br /> B. Inventor of Equipment Tested/Certified: <br /> Tank ID:Regular Master Tank Tank ID:Regular Slave Tank <br /> Nln-Tank Gauging Probe. Model: Mag 1 NIn-Tank Gauging Probe. Model: Mag Plus <br /> ®Annular Space Sensor. Model:794380-409 ®Annular Space Sensor. Model: 794380-409 <br /> ®Piping Sump Sensor(s). Model:794380-323 ®Piping Sump Sensor(s). Model: 794380-323 <br /> ®Fill Sump Sensor(s). Model: 794380-323 ®Fill Sump Sensor(s). Model:794380-323 <br /> ®Electronic Line Leak Detector. Model:V-R PLLD ❑ Line Leak Detector. Model: None <br /> ®Tank Overfill/High-Level Sensor. Model:V-R Audible ®Tank Overfill/High-Level Sensor. Model:V-R Audible <br /> N Fills ill Bucket Tested: ®Pass ❑Fail N Fillspill Bucket Tested: ®Pass ❑Fail <br /> Tank ID:Premium Tank Tank ID: <br /> N In-Tank Gauging Probe. Model:Mag 1 ❑In-Tank Gauging Probe. Model: <br /> ®Annular Space Sensor. Model:794380-409 E]Annular Space Sensor. Model: <br /> ®Piping Sump Sensor(s). Model:794380-323 ❑Piping Sump Sensor(s). Model: <br /> ®Fill Sump Sensor(s). Model:794380-323 ❑Fill Sump Sensor(s). Model: <br /> N Electronic Line Leak Detector, Model:V-R PLLD ❑ Line Leak Detector, Model: <br /> ®Tank Overfill/High-Level Sensor.Model:V-R Audible ❑Tank overfill/High-Level Sensor.Model: <br /> N Fillspill Bucket Tested: NPass ❑Fail ❑Fillspill Bucket Tested: ❑Pass ❑Fail <br /> Dispenser ID: 1&2 N Sump:NDry❑Water❑Product Dispenser ID:3&4 N Sump:NDry❑Water❑Product <br /> ❑Dispenser Containment Sensor(s).Model:794380-323 ❑Dispenser Containment Sensor(s).Model:794380-323 <br /> ❑Shear Valves) (Functional test) ❑Shear Valve(s) (Functional test) <br /> Dispenser ID:5&6 N Sump:NDry❑Water❑Product Dispenser ID:7&8 N Sump:NDry❑Water❑Product <br /> ❑Dispenser Containment Sensor(s).Model:794380-323 ❑Dispenser Containment Sensor(s).Model:794380-323 <br /> ❑Shear Valve(s) (Functional test) ❑Shear Valves (Functional test) <br /> Sump ID: ❑Sump: []Dry❑Water❑Product Sump ID: ❑ Sump:[]Dry❑Water❑Product <br /> F-1 Sump Containment Sensor(s).Model: El Sump Containment Sensor(s).Model: <br /> ❑Vapor Pot Annular Sensor(s).Model: ❑Shear Valves) (Functional test) <br /> ❑Vapor Pot High Level Sensor(s).Model: <br /> ❑Shear Valve(s) (Functional test) <br /> C. Certification-I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' <br /> guidelines. Attached to this Certification is a Plot Plan showing the layout of monitoring equipment. For any equipment capable of <br /> generating such reports,I have also attaUhdopyof the report; N System set-up N Alarm history report <br /> �4?Technician: Date: 2/14/12 <br /> Certification: Veeder- oot: B36 Level 4 <br /> ICC Cert: 8005930-UT <br />