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MONIT%RING SYSTEM CERTIPWATION MAKE / MODEL. OF MONITORING SYSTEM: Veeder-Root TLS-350 CERTIFICATION / TEST DATE: August 1, 2006 Al. FACILITY A2. OWNER Name 99 Shell Name Angle Enterprises Address 7700 Moreland Court, Stockton,CA 95212 Address 35584 Conavan Lane, Fremont,CA 94536 Phone# 209-939-1906 Phone# 510-552-4822 Contact Balaji Angle Contact Balaji Angle A3. C U P A A4. TESTING CONTRACTOR Name San Joaquin County Environmental Health Name Walton Engineering, Inc. Address 304 E Weber Avenue,3rd Floor,Stockton,CA 95202 Address P.O. Box 1025.W.Sacramento, CA 95691 Notified July 24, 2006 Lic# 617238 A, B. Haz Inspector Lori J. Luces Contact Richard Walton Phone# 209-468-9847 Phone# 916-825-3203 B. INVENTORY OF EQUIPMENT TESTED/CERTIFIED (Check the appropriate boxes to indicate equipment inspected/serviced) B1: TANKS Tank#1 (Product): Gasoline-87 Tank#2 (Product): Gasoline-91 ■ In-Tank Gauging Probe Model: 0847390-109 ■ In-Tank Gauging Probe Model: 0847390-109 ■ Annular Space or Vault Sensor Model: 0794380303 ■ Annular Space or Vault Sensor Model: 0794380-303 ■ Piping Sump/Trench Sensor(s) Model: 0794380-208 ■ Piping Sump/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: ❑ Tank Overfill/High-Level Sensor Model: ■ 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: 0847390-109 I ❑ 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/High-Level Sensor Model: ❑ Tank Overfill/High-Level Sensor Model: ■ Other (specify equipment in Section E) Model: ❑ Other (specify equipment in Section E) Model: 62: 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 Chains) ❑ 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 Float(s)and Chain(s) ❑ Dispenser Containment Float(s)and Chain(s) Dispenser#: Vent box Dispenser#: ■ Dispenser Containment Sensor(s) Model: 0794380.208 ❑ Dispenser Containment Sensor(s) Model: ❑ 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 inspectedlserviced 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 ��y!� WALTON Signature: '�` ENGINEERING,INC. Technician/Cert#: Bruce N.Stewart / A31131 5249892-UT Date: August 1, 2006 2006 Walton Engineering,Inc.