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P.O.Box 4208 <br /> AAV tec Petr _ Sonora CA 95370 <br /> Ca:623541 A-Haz <br /> Phone:209-532-7320 <br /> Compliance without Compromise Fax:209-533-2650 <br /> mail@alltechpetro.corn <br /> www.alitechpetro.com <br /> MONITORING SYSTEM CERTIFICATION <br /> A. General Information <br /> Facility Name: Arco #2186 Date of Testing/Servicing: February 11, 2013 <br /> Facility Address:3212 N. California St., Stockton CA 95204 <br /> Facility Contact Person: Wendy Facility Phone: 209-941-2694 <br /> LIA: San Joaquin County EHD;Inspector:Garrett Backus;LlA Phone: 209-468-2986; LIA Fax: 209-468-8392 <br /> Make/Model of Monitoring System: Veeder-Root TLS-350 LIA email; gbackus@sjcehd.com <br /> B. Inventory of Equipment Tested/Certified: <br /> Tank ID: Regular 87 Master Tank Tank ID: Regular 87 Slave Tank <br /> ®In-Tank Gauging Probe. Model: Mag 1 ®In-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 ❑None 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 /> ® Fillspill Bucket Tested: ®Pass [-]Fail ® Fillspill Bucket Tested: ®Pass []Fail <br /> Tank ID: Premium 91 Tank Tank ID: <br /> ® In-Tank Gauging Probe. Model: Mag 1 ❑In-Tank Gauging Probe. Model: <br /> ®Annular Space Sensor. Model: 794380-409 ❑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 /> ®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 /> ® Fillspill Bucket Tested: ®Pass ❑Fail ❑ Fillspill Bucket Tested: ❑Pass ❑Fail <br /> Dispenser ID: 1&2Z Sump: ®Dry❑Water E]Product Dispenser ID:3&4® Sump: ®Dry[—]water El Product <br /> ®Dispenser Containment Sensor(s).Model: 794380-323 ®Dispenser Containment Sensor(s). Model: 794380-323 <br /> ®Shear Valves Functional test ®Shear Valves Functional test <br /> Dispenser ID: 5&6® Sump: ®Dry❑Water❑Product Dispenser ID:7&8® Sump: ®Dry❑Water❑Product <br /> ®Dispenser Containment Sensor(s). Model: 794380-323 ®Dispenser Containment Sensor(s). Model:794380-323 <br /> ®Shear Valves Functional test ®Shear Valves Functional test <br /> Sump ID: ❑ Sump: ❑Dry❑Water❑Product Sump ID: ❑ Sump: ❑Dry❑Water❑Product <br /> ❑Sump Containment Sensor(s). Model: E]Sump Containment Sensor(s).Model: <br /> ❑Shear Valves Functional test ❑Shear Valves 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 attached a copy of the report; ® System set-up ®Alarm history report <br /> Technician: Date: 02/11/13 <br /> Certification: Veeder- oat: 1336 Level 4 <br /> ICC Cert: 8146912-UT <br />