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elk <br />F44 A I 1 `1 <br />IfflopUlmil <br />CERTIFICATION /TEST DATE: July 27,2016 <br />Ai. FACILITY <br />A2. OWNER <br />-.SAL,_ <br />Name <br />Quik Stop Market #11" <br />Name <br />Quik Stop Markets, Inc. <br />Address <br />7272 West Lane, Stockton, CA 95210 <br />Address <br />4567 Enterprise Street, Fremont, CA 94538 <br />Phone # <br />510-657-8500 <br />Phone # <br />510-657-8500 <br />Contact <br />Roser Batra <br />Contact <br />Debbie Markovich <br />D. RESULTS OF TESTING / SERVICING <br />Make / Model of Monitoring System: Veeder-Root TLS-350 SN# B0282976505001 <br />Software Version Installed: 2® <br />Complete the following checklist: <br />■ Yes ❑ No* Is the audible alarm operational? <br />N Yes C3 No* Is the visual alarm operational? <br />■ Yes 0 No* Were all sensors visually inspected, functionally tested, and confirmed operational? <br />■ Yes El No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment <br />will not interfere with their proper operation? <br />El Yes El No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modems) <br />M NIA operational? <br />■ Yes 0 No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br />El N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate <br />positive shutdown? (check all that apply) N Sump/Trench sensors; 0 Dispenser Containment Sensors. <br />N Yes El No* Did you confirm positive shut -down due to leaks and sensor failure/disconnection? <br />El Yes 171 No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br />N N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br />fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? % <br />0 Yes No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced <br />and list the manufacturer name and model for all replacement parts in Section E, below. <br />■ Yes No Was any liquid found inside any secondary containment systems designed as dry systems? <br />(Check all that apply) El Product; N Water. If yes, describe causes in Section E, below. <br />■ Yes ❑ No* Was monitoring system set-up reviewed to insure proper settings? Attach set-up reports, if applicable. <br />0 Yes El No* Is all monitoring equipment operational per manufacturer's specifications? <br />In Section E below, describe how and when these deficiencies were or will be corrected. <br />E. COMMENTS <br />Removed liquid from 87 & 91 STP sumps, and 89 & 91 fill sumps. <br />Replaced battery on monitor. <br />Page 2 of 3 <br />