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Jun 17 05 06:26p Mike Dotten (209) 533-2650 ei Alitechl 17759 Buttercup Circle, Sonora, CA 95370 Phone: 209-532-7320; Fax: 209-533-2550 California Tank Tester: 90-1068 California Contractor 623541 A-Haz alltech@mlode.com A. General Information Facility Name: Mossdale Arco Date of Testing/Servicing: June 9, 2005 Facility Address: 444 Mossdale Rd., Lathrop CA Facility Contact Person: Nick Bokides Contact Phone No.: (209) 649-3808 LIA: San Joaquin; Ray von Flue Make/Model of Monitoring System: Veeder-Root TLS -350 B. Inventory of Equipment Tested/Certified: Cheek the annronrinte taxes to indieste merifir enninment insnertedherviredt lil Tank ID: Regular Compartment Tank ID: Supreme Compartment M In -Tank Gauging Probe. Model: Mag 1 ® In -Tank Gauging Probe. Model: Mag 1 ® Annular Space or Vault Sensor. Model: Float Switch (Shared) ® Annular Space or Vault Sensor. Model: (Shared) ® Piping Sump / Trench Sensor(s). Model: Liquid sensor ® Piping Sump / Trench Sensor(s). Model: Liquid sensor ❑ Fill Sump Sensor(s). Model: ❑ Fill Sump Sensor(s). Model: ® Mechanical Line Leak Detector. Model: Red Jacket XL ® Mechanical Line Leak Detector. Model: Vaporless LD -2000 ❑ Electronic Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model- ® Tank Overfill / High -Level Sensor. Model: Drop Tube ® Tank Overfill / High -Level Sensor. Model: Drop Tube Other ❑ Other Tank ID: Diesel Compartment Tank ID: M In -Tank Gauging Prof. Model: Mag 1 ❑ In -Tank Gauging Probe. Model: ® Annular Space or Vault Sensor. Model: Shared ❑ Annular Space or Vault Sensor. Model: ® Piping Sump / Trench Sensor(s). Model: Liquid sensor ❑ Piping Sump / Trench Sensor(s). Model: ❑ Fill Sump Sensor(s). Model: ❑ Fill Sump Sensor(s). Model: ® Mechanical Line Leak Detector. Model: Vaporless LD -2000 ❑ Mechanical Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model: ® Tank Overfill / High -Level Sensor. Model: Drop Tube ❑ Tank Overfill / High -Level Sensor. Model: ❑ Other ❑ Other Dispenser ID: 1&2 M Sump: MDry ❑Water [-]Product Dispenser ID: 3&4 M Sump: ®Dry ❑Water ❑Product M Dispenser Containment Sensor(s). Model: Liquid sensor M Dispenser Containment Sensw(s). Model: Liquid sensor M Shear Valve(s) (Functional test) M Shear Valve(s) (Functional test) ❑ DD user Containment Float(s) and Chain(s). ❑ Dis nser Containment Float s) and Chain(s). Dispenser ID: 5&6 M Sump: ®Dry []Water ❑Product Dispenser ID: 7&8 M Sump: ®Dry ❑Water ®Product ® Dispenser Containment Scnsor(s). Model: Liquid sensor M Dispenser Containment Sensor(s). Model: Liquid sensor ® Shear Valve(s) (Functional test) 0 Shear Valve(s) (Functional test) ❑DigLenser Containment Floats and Chain(s). ❑ Dispenser Containment Float s) and Chain(s). Dispenser ID: 9&10 M Sump: ®Dry ®Water ❑Product Dispenser ID: I1&12 M Sump: ®Dry []Water [I Product ® Dispenser Containment Sensor(s). Model: Liquid sensor M Dispenser Containment Sensor(s). Model: Liquid sensor Shear Valve(s) (Functional test) M Shear Valve(s) (Functional test) ❑ Disp5nser Containment FI s) and Chain(s). ❑ Dispenser Containment Floats and Chains . C. Certification - I certify that the equipment identified in this document was inspected/serviced 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 a report; (cheek all that apply): ® System set-up ® Alarm history report Technician: L Mike Dotten, California Contractor's License 623541 A -Naz Certification: Veeder-Root: 006-05-0789; Level 4. ICC UST Technician # 5259412 -UT Page l of 3 06/05