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OCT-01-2008 01 :48 PM GETTLER—RYAN INC. 925 551 4770 P. 02 s MONITORING TF CERTIFICATION For(lvvv 8.1-Al/.1111I.crlictiuns Within the,State of Califi)rnia Authur'in.'Cited; Chctpinr•r`.7, Health rind Sa/,,v Code,- Chapler /h, Dh isiem i, Title,_".i, Cellifurniet Code of Regulations This £tinct Must be used to doeumeni testing and ,.crvicing of monitoring vquipme:nt. A separate cervi tk,W,f�euf� �lw�;2m)jadu each iYlt?ll tin c , anI-r@L=qj by the technician who prrlimns the work. A copy tit thio form must he provided to the tank systern owner/operator. The ownur)operator must submit it cttliy ofthis firm to the local agcney reaguluting I:ti r systunis within 30 days of test date. A. General Information Facility Name: Arco _. _. Bldg, No.:._ Site Address- 2908_Seniamin Holt Dr_ City: Stockton � Zip: Facility Contact>'erson: C ontact Phone.No.: Make,'Model of Monitoring System: TLS-350 Date of"Costing/Scrviciw,: 912/2008 B. Inventory of Equipment Tested/Certified Check then ropri■te!coxes to Indicate x ecific a u( meet ins ectcd/serviced: Tank ID; 91 _ _ l'ttnk lD: ®in-Tank Gauging Probe. Model: ❑In=tank Civaging Pn�bc Model: �r- - ®Annular Space or Vault Sensor. Miedel: � ❑ Annulm Space tit Vault Senwtr, Model: 0 Piping Sump i Trench Sensor(,.!. Model: _ (� Piping Sump Trench Sens<ut s 1. Model: 13 Pill Sump St.•nnorio, Model: 794380-323 (�Fill Sunip Soisorts) Mtxld: M Mechanical Line Leak Detector. Madel' ❑Metihanical!sine Leak Detector. Model: ❑Electronic Line Leak Detector. Model: ❑L.Ixt tour Line Leak f&L%!atr. model: ®'Tank Overfill High-Level Sensor Mode]7 lank Overfill, High•Level Sensor. Model: ❑Other(specify equipmoit type and model in Sectio i E on Pate 2). Other I spceiN equipment typo and model in Section E.on Pugs:2). Tank ID:_ Tnnk ID: _ D In•Tdnk Gauging Pnibe, M tdel �. .® ❑ hl•T'auk Gauping Probe. Model: D Annular Space or Vault Sensor Model: �v � ❑ ,0.nnular Spue or Vault Sensor. Model: �,�-�---.... . ..... D Piping Sump r Trench Scimilst, Model: ❑Piping sunir Crcne:h Scnsonsl. Model: [}Fill Sump Sensor(st. Model: � ❑till Sump Srnsottsr. Madel: - ®Mechanical Line teak Detector Model: D Mct hunicuE l..inr 1.4ak VOccior. Model; - []r4m:tronic Lina Leak Detector. Model: ❑Elmironic line L.rrak i futcctor, Model: ❑Tank Overfill i High-Level Sensor. Model: 0'yank o%crtill Hi}h-Level Sensor. Modd: ❑Other(specify equipment type and model in Station F nn Pa¢tt'M 1. ❑Other(sptwily equipinenl type and nwdel in Soction t:on Page 21.v Dispenser ID: Dispenwr ID;. ❑Dispeiiwr Containment Season s). Mi.clel: U3 Dispoiwr Containment Sensor(s). Moc(al: ... Cl Shear Valveoo (_]Shear valad.), ❑Dir penser Contaittttmcm float(s)and Chain(,.), 0 Dispenser Containment Floar(s)and ChainW. SWUM Dispenser ID:_ - _ -- _w Dispenser ll): 17 Dispenser Containment Samotts). Madel' n Di,.pcnscrContainment Senlwu(s) Model: Cl Shear Valveys). (l Shear Valvc(�). ❑Dispenser Containment F'lotion)and Chitin(,.). ❑DkpenscrC'ontainment Float(s)and Chain(s). Dispenser ID: Dispenser 1D:. ©DibpenserContainment Sensans). Model: �- �] Dispenser Containment Suilwr(s) Model: ❑Shear Valve(s). Shear vaheis). Q Dispenser Containment l+loags)and Chain(,.). []Dispcnsvr Containment Floal(s)and Chain(,.►. +if tha facility contains more:tanks or dispensers,copy this Conn. Include inlirnnation tier t;vcry tank and dispenser at the facility C. Certification-i certify that the equipment identified in this document was lnspected/serviced in accordance with the manufacturers' guidelltift 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 equilliment capable of generating such reports.I have also attached a copy of the report;feheck all that appir): System set-up L.J Alarm history report Technician Name(print): Jose Carrasco Signature: Certification No.: license, No.: ......... _...._.. ___ 'Testing Company Name: Gettler-R an Inc. _ �..___.___._..–.._..,, F'ht,ne No.: 9 951-T5..1-—---.—--—-- Testing Company Address: —6747 Sierra Ct.. Ste J Dublin Ca I)an:of Testing/Servicing;;: 9/2/2008 Page 1 of 3 Rev(V08)