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MONITORING SYSTO CERTIFICATION - G§ge 1 i� <br /> MAKE / MODEL OF MONITORING SYSTEM: Gilbarco EMC iL <br /> CERTIFICATION /TEST DATE: December 17, 2014 1 i.L <br /> Al. FACILITY A2. OWNER <br /> Name Flyers#427 Name Flyers Energy LLC. %< '" <br /> Address 3300 Waterloo Road,Stockton,CA 95205 Address 2360 Lindbergh Street,Aubtip!„GA AMP , <br /> Phone# 530-885-0401 Phone# 530-885-0401 <br /> Contact Amanda Ap elt I I Contact Amanda A pelt <br /> B. INVENTORY OF EQUIPMENT TESTED/CERTIFIED (check the appropriate boxes to indicate equipment Inspected/serviced) <br /> B1 (Continued): TANKS <br /> Tank#5 (Product): Tank#6 (Product): <br /> ❑ In-Tank Gauging Probe Model: ❑ In-Tank Gauging Probe Model: <br /> ❑ Annular Space or Vault Sensor Model: ❑ Annular Space or Vault Sensor Model: <br /> ❑ Piping Sump/Trench Sensor(s) Model: ❑ Piping Sump/Trench Sensor(s) Model: <br /> ❑ Fill Sump Sensor(s) Model: ❑ Fill Sump Sensor(s) Model: <br /> ❑ Mechanical Line Leak Detector Model: ❑ Mechanical Line Leak Detector Model: <br /> ❑ Electronic Line Leak Detector Model: ❑ Electronic Line Leak Detector Model: <br /> ❑ Tank Overfill/High-Level Sensor Model: ❑ Tank Overfill/High-Level Sensor Model: <br /> ❑ Other (specify equipment in Section E) Model: ❑ Other (specify equipment in Section E) Model: <br /> Tank#7 (Product): Tank#8 (Product): _ <br /> ❑ In-Tank Gauging Probe Model: ❑ In-Tank Gauging Probe Model: <br /> ❑ Annular Space or Vault Sensor Model: ❑ Annular Space or Vault Sensor Model: <br /> ❑ Piping Sump/Trench Sensor(s) Model: ❑ Piping Sump/Trench Sensor(s) Model: <br /> ❑ Fill Sump Sensor(s) Model: ❑ Fill Sump Sensor(s) Model: <br /> ❑ Mechanical Line Leak Detector Model: ❑ Mechanical Line Leak Detector Model: <br /> ❑ Electronic Line Leak Detector Model: ❑ Electronic Line Leak Detector Model: <br /> ❑ Tank Overfill/High-Level Sensor Model: ❑ Tank Overfill/High-Level Sensor Model: <br /> ❑ Other (specify equipment in Section E) Model: ❑ Other (specify equipment in Section E) Model: <br /> 132: (Continued) DISPENSERS/UDC's <br /> Dispenser#: 8-9 Dispenser#: 10 <br /> ❑ Dispenser Containment Sensor(s) Model: ❑ Dispenser Containment Sensor(s) Model: <br /> ■ Shear Valves ■ Shear Valves <br /> ■ Dispenser Containment Float(s)and Chain(s) ■ Dispenser Containment Float(s)and Chain(s) <br /> Dispenser#: Dispenser# <br /> ❑ Dispenser Containment Sensor(s) Model: ❑ Dispenser Containment Sensor(s) Model: <br /> ❑ Shear Valves <br /> ❑ Shear Valves <br /> ❑ Dispenser Containment Float(s)and Chain(s) ❑ Dispenser Containment Float(s)and Chain(s) <br /> Dispenser#: Dispenser# <br /> ❑ Dispenser Containment Sensor(s) Model: ❑ Dispenser containment Sensor(s) Model: <br /> ❑ Shear Valves ❑ Shear Valves <br /> ❑ Dispenser Containment Float(s)and Chain(s) ❑ Dispenser Containment Float(s)and Chain(s) <br /> Dispenser#: Dispenser#: <br /> ❑ Dispenser Containment Sensor(s) Model: ❑ Dispenser Containment Sensor(s) Model: <br /> ❑ Shear Valves ❑ Shear Valves <br /> ❑ Dispenser Containment Float(s)and Chain(s) ❑ Dispenser Containment Float(s)and Chain(s) <br /> Dispenser#: Dispenser# <br /> ❑ Dispenser Containment Sensor(s) Model: ❑ Dispenser Containment Sensor(s) Model: <br /> ❑ Shear Valves ❑ Shear Valves <br /> ❑ Dispenser Containment Float(s)and Chaln(s) ❑ Dispenser Containment Float(s)and Chain(s) <br /> Dispenser#: Dispenser# <br /> ❑ Dispenser Containment Sensor(s) Model: ❑ Dispenser Containment Sensor(s) Model: <br /> ❑ Shear Valves ❑ Shear Valves <br /> ❑ Dispenser Containment Float(s)and Chain(s) ❑ Dispenser containment Float(s)and Chain(s) <br /> ©2014 Walton Engineering,Inc. <br /> Page 1a of 3 <br />