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OITCTRIG SYSTEM CERTIFICATION JUN 07 2016 <br />CERTIFICATION /TEST DATE: June 2, 2016 <br />- .flr,'Y�"', <br />e <br />Al. FACILITY <br />A2. OWNER <br />Name Quik Stop Market #121 <br />Name Quik Stop Markets, Inc. <br />- <br />Address 1196 W. Louise Avenue, Manteca, CA 95336 <br />Address 4567 Enterprise Street, Fremont, CA 94538 <br />Phone # 510-657-8500 <br />Phone # 510-657-8500 <br />Contact Roger Batra <br />Contact Debbie Markovich <br />D. RESULTS OF TESTING / SERVICING <br />Make / Model of Monitoring System: Gilbarco EMC SN# 80447883805001 <br />Software Version Installed: 330.01 <br />5. <br />Complete the following checklist: <br />rU.�, <br />■ Yes ❑ No* Is the audible alarm operational?' <br />E ■ Yes <br />❑ No* <br />Is the visual alarm operational? <br />r <br />�M <br />■ Yes <br />❑ No' <br />Were all sensors visually inspected, functionally tested, and confirmed operational? <br />■ Yes <br />❑ No* <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment <br />u <br />will not interfere with their proper operation? <br />❑ Yes <br />❑ No* <br />If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modems) <br />Kau <br />'�� <br />■ N/A <br />operational? _ <br />■ Yes <br />❑ No* <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br />j; <br />❑ N/A <br />monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate <br />f <br />=7= <br />positive shutdown? (check all that apply) ■ Sump/Trench sensors; ❑ Dispenser Containment Sensors. <br />w <br />cif <br />■ Yes <br />❑ No* <br />Did you confirm positive shut -down due to leaks and sensor failure/disconnection? <br />❑ Yes <br />❑ No* <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br />� <br />■ N/A <br />mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br />'o <br />fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? /a <br />f� El Yes Yes * <br />■ No <br />Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced <br />a' <br />and list the manufacturer name and model for all replacement parts in Section E, below. <br />t <br />■ Yes * <br />❑ No <br />Was any liquid found inside any secondary containment systems designed as dry systems? <br />(Check all that apply) ❑ Product; ■ Water. If yes, describe causes in Section E, below. <br />■ Yes <br />❑ No* <br />Was monitoring system set-up reviewed to insure settings? Attach set-up reports, if applicable. <br />21, <br />proper <br />■ Yes ❑ 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 />�f <br />a'47KOMBI`tibli 01 i i" "8=— OWN* <br />E. COMMENTSpill <br />Replaced the battery on the monitor. <br />Removed liquid from 87 and 91 fill sumps. <br />� <br />ti - <br />1 <br />r, <br />i <br />-- <br />s <br />02016 Walton Engineering, Inc. <br />Page 2 of 3 <br />