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MONITORING SYSTEM CERTIFICATION <br />CERTIFICATION / TEST DATE: March 5, 2012 <br />Al. FACILITY <br />Make / Model of Monitoring System: Veeder-Root TLS -350 <br />Software Version Installed: 332.00 <br />A2. OWNER <br />■ Yes ❑ No* Is the audible alarm operational? <br />Name <br />7 -Eleven Market #2368 / Store #19976 <br />❑ No* <br />Name <br />7 -Eleven, Inc <br />Address <br />1399 N. Main Street, Manteca, CA 95336 <br />❑ No* <br />Address <br />P.O. Box 711, Dallas, TX 75221 <br />Phone# <br />209-239-3252 <br />❑ No* <br />Phone# <br />805-523-2949 <br />Contact <br />Stephen Boyd <br />contact <br />Stephen Boyd <br />D. RESULTS OF TESTING / SERVICING <br />Make / Model of Monitoring System: Veeder-Root TLS -350 <br />Software Version Installed: 332.00 <br />Complete the following checklist: <br />■ Yes ❑ No* Is the audible alarm operational? <br />■ Yes <br />❑ No* <br />Is the visual alarm operational? <br />■ Yes <br />❑ No* <br />Were all sensors visually inspected, functionally tested, and confirmed operational? <br />■ Yes <br />❑ No* <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment <br />will not interfere with their proper operation? <br />■ Yes <br />❑ No* <br />If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modems) <br />❑ NIA <br />operational? <br />■ Yes <br />❑ No* <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br />❑ N/A <br />monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate <br />positive shutdown? (check all that apply) ■ Sump/Trench sensors; ■ Dispenser Containment Sensors. <br />■ Yes <br />❑ No* <br />Did you confirm positive shut -down due to leaks and sensor failure/disconnection? <br />❑ Yes <br />❑ No* <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br />■ N/A <br />mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br />fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? % <br />■ Yes * <br />❑ No <br />Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced <br />and list the manufacturer name and model for all replacement parts in Section E, below. <br />■ Yes * <br />❑ No <br />Was any liquid found inside any secondary containment systems designed as dry systems? <br />(Check all that apply) ❑ Product; ■ Water. If yes, describe causes in Section E, below. <br />■ Yes <br />❑ No* <br />Was monitoring system set-up reviewed to insure proper settings? Attach set-up reports, if applicable. <br />■ Yes <br />❑ No* <br />Is all monitoring equipment operational per manufacturer's specifications? <br />* In Section E below, describe how and when these deficiencies were or will be corrected. <br />E. COMMENTS <br />Replaced the ECPU2 board. <br />A small amount of liquid was removed from the 87 fill sump. <br />Page 2 of 3 <br />