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MONITCONG SYSTEM CERTIFIDATION MAKE / MODEL OF MONITORING SYSTEM: Veeder-Root TLS-350 CERTIFICATION / TEST DATE: October 25, 2011 Al. FACILITY A2. OWNER Name BP# 29 Cruisers Manteca Name Boyett Petroleum Address 1137 W. Lathrop Road, Manteca, CA 95336 Address 601 McHenry Avenue, Modesto, CA 95350 Phone# 209-824-2760 Phone# 209-577-6000 Contact Rohda Henry Contact Rohda Henry A3. C U P A A4. TESTING CONTRACTOR Name San Joaquin County Environmental Health Name Walton Engineering, Inc. Address 600 E. Main Street,Stockton, CA 95202 Address P.O. Box 1025,W. Sacramento, CA 95691 Notified October 10, 2011 Lic# 617238 A, B, Haz Inspector Muniappa Naidu Contact Dulcinea Covan Phone# 209-468-8257 Phone# 916-373-1166 B. INVENTORY OF EQUIPMENT TESTED/CERTIFIED (Check the appropriate boxes to indicate equipment inspected/serviced) 61: TANKS Tank#1 (Product): Gasoline-87 Tank#2 (Product): Gasoline-91 ■ In-Tank Gauging Probe Model: 0846390-109 ■ In-Tank Gauging Probe Model: 0846390-109 ■ Annular Space or Vault Sensor Model: 0794390420 ■ Annular Space or Vault Sensor Model: 0794390420 ■ Piping Sump I Trench Sensor(s) Model: 0794380-208 ■ Piping Sump I Trench Sensor(s) Model: 0794380-208 ■ Fill Sump Sensor(s) Model: 0794380-208 ■ Fill Sump Sensor(s) Model: 0794380-208 ❑ Mechanical Line Leak Detector Model: ❑ Mechanical Line Leak Detector Model: ■ Electronic Line Leak Detector Model: 0848480-001 ■ Electronic Line Leak Detector Model: 0848480-001 ■ Tank Overfill/High-Level Sensor Model: 0846390-109 ■ Tank Overfill/High-Level Sensor Model: 0846390-109 ■ Other (specify equipment in Section E) Model: ■ Other (specify equipment in Section E) Model: Tank#3 (Product): Diesel Tank#4 (Product): ■ In-Tank Gauging Probe Model: 0846390-109 ❑ In-Tank Gauging Probe Model: ❑ Annular Space or Vault Sensor Model: ❑ Annular Space or Vault Sensor Model: ■ Piping Sump/Trench Sensor(s) Model: 0794380-208 ❑ Piping Sump/Trench Sensor(s) Model: ■ Fill Sump Sensor(s) Model: 0794380-208 ❑ Fill Sump Sensor(s) Model: ❑ Mechanical Line Leak Detector Model: ❑ Mechanical Line Leak Detector Model: ■ Electronic Line Leak Detector Model: 0848480-001 ❑ Electronic Line Leak Detector Model: ■ Tank Overfill I High-Level Sensor Model: 0846390-109 ❑ Tank Overfill/High-Level Sensor Model: ■ Other (specify equipment in Section E) Model- ❑ Other (specify equipment in Section E) Model: B2: DISPENSERS/UDC's Dispenser#: 1-2 Dispenser#: 3-4 ■ Dispenser Containment Sensor(s) Model: 0794380-208 ■ Dispenser Containment Sensor(s) Model: 0794380-208 ■ Shear Valves ■ Shear Valves ❑ Dispenser Containment Float(s)and Chain(s) ❑ Dispenser Containment Float(s)and Chain(s) Dispenser#: 5-6 Dispenser#: 7-8 ■ Dispenser Containment Sensor(s) Model: 0794380-208 ■ Dispenser Containment Sensor(s) Model: 0794380-208 ■ Shear Valves ■ Shear Valves ❑ Dispenser Containment Floats)and Chain(s) ❑ Dispenser Containment Float(s)and Chain(s) Dispenser#: 9-10 Dispenser#: 11-12 ■ Dispenser Containment Sensor(s) Model: 0794380-208 ■ Dispenser Containment Sensor(s) Model: 0794380-208 ■ Shear Valves ■ Shear Valves ❑ Dispenser Containment Float(s)and Chain(s) ❑ Dispenser Containment Float(s)and Chain(s) C. CERTIFICATION I certify that the equipment identified in this document was ins pectedlseryiced 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 a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports,I have also attached a copy of the report: (check all that apply): ■ System set-up ■ Alarm History Report WALTON. Signature: ._NGINEERING.INC. Technician/Cert#: Curtis Carpenter/B37258 8020679 Date: October 25,2011 2011 Walton Engineering,Inc.