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05/03/2007 09:40 2099519352 VILLAGE WEST MARINA PAGE 02 Alltech Petro Inc. 17759 Buttercup Circle, Sonora, CA 95370 Phone: 209-532-7320: Fax- 209-533-2650 California Contractor 623541 A-Haz mike@aUteclapetro.com MONITORING SYSTEM CERTIFICATION it A. General Information Facility Name: Village West Marinas Date of Testing/Servicing: March 28, 2007 Facility Address: 6649 Embarcadero Drive, Stockton CA 95217 Facility Contact Person: Mike Spence Contact Phone No.: 209-951-1551 Regulatory agency: Sara Joaquin Health; Inspector: Toun Yang; Phone: 468-9847; Fax 469-3433. Make/Model of Monitoring System' Veeder5-Root TLS 3501 This test report is a: 0 Final Report (Facility was observed to be in Compliance) or a: ❑ Prelimieary Report (Unresolved Issues Exist) B I f E Tested/Certified: n�vento o u1 sent Tank ID: Regular Tank Tank ID: Diesel Tank [3 to -Tank Gauging Probe. Model: Bone ❑ In -Tank Gauging Probe. Model: None N Annular Space or Vault Sensor. Model: 794380-304 ® Annular Speoe or Vault Sensor. Model: 794380-304 ® Piping Sump / Trench Sensor(s). Model: 794380-301 Piping Sump / Trench Sensor(s). Model: 794380.301 ❑ Fill Sump Sensor(s). Model: ❑ Fill Sump Sensor(s). Model: N Mechanical Line Leak Detector. Model: Red Jacket Diaph. 0 Mechanical Line Leak Detector. Model: Vaporless LD -2000 C3 Electronic Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model: ® Tank Ove�ll / High -Level Sensor_ Model: Drop Tube Tank Ovafili / High -Level Sensor. Model: Drop Tube El Other Other Tank m: Tank ID: ❑ In -Tank Gauging Probe. Model: ❑ In -Tank Gauging Probe. Model: ❑ Annular Space or Vault Sensor. Model: ❑ Annular Space or Vault Sensor_ Mode;: ❑ .Piping Sump / Trench Scnsor(s)- Model,. [ 3 Piping Sump / Trench Sensor(s). Model: ❑ Fill Sump Sensor(s). Model. ❑ Fill Sump Sensor(s). Model: ❑ Mechanical Line Leak Detector. Model: ❑ Mechanical Line Leak Detector_ Model: ❑ Electronic Line Leak Detector. Modell. ❑ Electronic Line Leak Detector. Model: Q Tank Overfill / Iligb-Level Sensor. Model: ❑ Tank Overfill / High -Level Sensor. Model: ❑ Other El Other Dispeascr ID: I ® Sump: ElDry ❑Water ❑Product Dispenser ID: 2 M Sump' ODry ❑Water ❑product ❑ Dispenser Containment Sensor(s). Model: ❑ Dispenser Containment Scrwor(s). Model; N Shear Valve(s) (Functional test) ® Shear Valve(s) (Funetionai test) Dispenser Containment Floats and Chain(s). N Di user Containment Float(s) and Chain(s). Dispenser 1D: 3 ® Sump: ®Dry O Water ❑Product Dispenser ID: ❑ Sump' ❑Dry ❑ Water ❑Product 0 Dispenser Containment Semsor(s)_ Model: ❑ Dispenser Containment Sensor(s). Model: ® Shear Valve(s) (Functional tact) Q Shear Valvc(s) (Functional test) M Dispew9cr Containment Float(s) and Chaim 4 - Lj Dis nser Containment Flo! s and Chain(s). Dispenser ID: ❑ Sump: ❑Dry ❑Water ❑Product Dispenser ID: ❑Sump: _]Pry []Water ❑Product ❑ Dispenser Containment Sensor(s). Model: ❑ Dispenser Containment Sensor(s). Model: Q Sbear Valve(s) (Functional test) ❑ Shear Valve(s) (Functional test) Dispcn5cr Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chains _ C. Certification - .I certify that the equipment identified in this document was inspeeted/serviced in accordance with the manufacturers' guidelines. Attached to this Certification Is information (e.g. manufacturers' checklists) necessary to verify that this information Is correct and it Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, l have also attached x copy of the report; (ckeck 0 Mat appy): Z System set-up 0 Alarm history report Technician: 11%e;6 1,. . Certification: Veeder-Root:006-050799 ; Level 4. Mike Dotten, California Contractor License. No.: 623541 ICC UST Service Technician # 5259412 -UT. Page 1 of 3 413N r