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0 <br /> RECEIVED <br /> P.O.Box 4208 <br /> FEB 1 2013 Sonora CA 95370 <br /> Ca:623541 A-Haz <br /> AlitechPett'"6- ENVIRONMENTAL HEALTH Phone:209-532-7320 <br /> Compliance without Compromise PER[IRT/SERVICES Fax:209-533-2650 <br /> mail@alltechpetro.com <br /> www.alltechpetro.com <br /> MONITORING SYSTEM CERTIFICATION <br /> A. General Information <br /> Facility Name: Arco #2133 Date of Testing/Servicing: January 23, 2013 <br /> Facility Address:2908 Benjamin Holt Dr., Stockton CA 95207 <br /> Facility Contact Person: Laurence Facility Phone: 209-478-5552 <br /> LIA: San Joaquin Environmental Health;inspector:Jeff Wong;LIA Phone: 209-468-3448; LIA Fax: <br /> Make/Model of Monitoring System: Veeder-Root TLS-350 <br /> B. Inventog of Equipment Tested/Certified: <br /> Tank ID:Regular Master Tank Tank ID:Regular Slave Tank <br /> Nln-Tank Gauging Probe. Model:Mag 1 Uln-Tank Gauging Probe. Model: Mag 1 <br /> [E Annular Space Sensor. Model:794380-420 NAnnular Space Sensor. Model:794380-420 <br /> 1Z Piping Sump Sensor(s). Model:794380-323 EPiping Sump Sensor(s). Model:794380-323 <br /> E Fill Sump Sensor(s). Model:794380-323 N Fill Sump Sensor(s). Model:794380-323 <br /> EElectronic Line Leak Detector. Model:V-R PLLD NAGT Sump Sensor Model:794380-323 <br /> ZTank Overfill/High-Level Sensor.Model:V-R Audible MTank Overfill/High-Level Sensor.Model:V-R Audible <br /> [Z Fillspill Bucket Tested: NPass []Fail N fills ill Bucket Tested: E Pass [JFail <br /> Tank ID:Premium Tank Tank ID: <br /> ER In-Tank Gauging Probe. Model:Mag 1 Elln-Tank Gauging Probe. Model: <br /> ZAnnular Space Sensor. Model:794380-420 []Annular Space Sensor. Model: <br /> Z Piping Sump Sensor(s). Model:794380-323 El Piping Sump Sensor(s). Model: <br /> ZFill Sump Sensor(s). Model:794380-323 F]Fill Sump Sensor(s). Model: <br /> ER Mechanical Line Leak Detector. Model:VMI LD-2000 E] Line Leak Detector. Model: <br /> ETank Overfill/High-Level Sensor.Model:V-R Audible RTank Overfill/High-Level Sensor.Model: <br /> Z Fillspill Bucket Tested: [EPass nFail E:1 Fillspill Bucket Tested []Pass []Fail <br /> Dispenser ID: 1&2 N Sump:MDry Dwater 4 Dlispenser ID::3&4,0 Surno:ZDry E]Water ElProduct <br /> Z Dispenser Containment Sensor(s).Model:794386= 23 eriser"bantainnierit Sensor(s).Model:794380-323 <br /> NShear Valves) (Functional test) -ear'Va 00,1 u0�natt St <br /> Dispenser ID: 5&6[0 Sump:ODry Elwater Qj-tocl4d, 611spen'see,10:7'&&0 Sump:'961rlyl 0 T ElProduct <br /> Dispenser Containment Sensor(s).Model:7943td�'3 ­' El Dispertseres'Contaihment Sensor(s).Model:-794380-323 <br /> EShear Valves) Functional test ❑Shear Va14eWIff, i'onat test. <br /> Sump ID:N.Vapor Pot[E Sump: ZDry[]water E]Product Sump ID:Transitidrfff'Sump:ZDry DWater"T"I"'Troduct <br /> 2 Sump Containment Sensor(s).Model:794380-323 ❑Sump Containment" <br /> Sen,sor(s),Model-79438 J <br /> Z Vapor Pot Annular Sensor(s). Model:794380-420 <br /> ZVapor Pot High Level Sensor�sj.Model:794380-420 <br /> a <br /> C. Certification-I certify that the equipment identified in this document was inspected/serviced in accordance with'th6`,MirrVuf6cturers' <br /> guidelines. Attached to this Certification is a Plot Plan showing the layout of monitoringrtr ent For any equipment cI f <br /> EAp4b e o <br /> generating such repos,I have also attached a copy of the report; System set-up historyreport <br /> Technician: ./,"Date:,1123/13 <br /> Certification: Veeder-Root: B36877 Level 4 <br /> ICC Cert: 8152115-UT <br />