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MONITORING SYSTEM CERTIFICATION MAKE / MODEL OF MONITORING SYSTEM : Veeder- Root TLS -350 CERTIFICATION / TEST DATE : December 06 , 2017 Al . FACILITY A2 . OWNER Name Colonial Energy #40134 Name Colonial Energy , LLC . Address 1434 W. Yosemite Avenue , Manteca , CA 95337 Address 2860 N . Santiago Blvd . 2nd Floor, Orange , CA 92867 Phone # 916 -285-7402 Phone # 714 -761 -5426 Contact Station Manager Contact Victor Hassan A3 . C U P A A4 . TESTING CONTRACTOR Name San Joaquin County Environmental Health Name Walton Engineering , Inc . Address 1868 E . Hazelton Avenue , Stockton , CA 95202 Address P . O . Box 1025 , W . Sacramento , CA 95691 Notified November 21 , 2017 Lic # 617238 A , B , Haz Inspector John/Zuna Contact Veronica Freitas Phone # 209 -468-3442 Phone # 916 -373-1166 B . INVENTORY OF EQUIPMENT TESTED/CERTIFIED (Check the appropriate boxes to indicate equipment inspected/serviced ) B1 : TANKS Tank #1 ( Product) : 87 Tank #2 (Product) : 89 ❑ In -Tank Gauging Probe Model : ❑ In -Tank Gauging Probe Model : Annular Space or Vault Sensor Model : 0794390420 Annular Space or Vault Sensor Model : 0794390-420 Piping Sump / Trench Sensor(s) Model : 0794380 -208 Piping Sump I Trench Sensor(s) Model : 0794380 -208 ❑ Fill Sump Sensor(s) Model : ❑ Fill Sump Sensor(s) Model : Mechanical Line Leak Detector Model : VMI 99LD -2000 Mechanical Line Leak Detector Model : VMI 99LD-2000 I ❑ Electronic Line Leak Detector Model : ❑ Electronic Line Leak Detector Model : ❑ Tank Overfill / High -Level Sensor Model : ❑ Tank Overfill / High -Level Sensor Model : ❑ Other (specify equipment in Section E ) Model : ❑ Other (specify equipment in Section E) Model : Tank #3 ( Product) : 91 Tank #4 (Product) : ❑ In -Tank Gauging Probe Model : ❑ In -Tank Gauging Probe Model : 0 Annular Space or Vault Sensor Model : 0794390420 ❑ Annular Space or Vault Sensor Model : 0 Piping Sump I Trench Sensor(s) Model : 0794380-208 ❑ Piping Sump I Trench Sensor(s) Model : ❑ Fill Sump Sensor(s) Model : ❑ Fill Sump Sensor(s) Model : Mechanical Line Leak Detector Model : VMI 99LD-2000 ❑ Mechanical Line Leak Detector Model : i ❑ Electronic Line Leak Detector Model : ❑ Electronic Line Leak Detector Model : ❑ Tank Overfill / High -Level Sensor Model : ❑ Tank Overfill / High -Level Sensor Model : ❑ Other (specify equipment in Section E ) Model : ❑ Other (specify equipment in Section E ) Model : 132 : DISPENSERS/UDC's Dispenser # : 1 -2 Dispenser # : 3 =4 0 Dispenser Containment Sensor(s) Model : 0794380 -208 E Dispenser Containment Sensor(s) Model : 0794380 -208 ❑ Shear Valves � ElShear Valves ElDispenser Containment Float(s) and Chain (s) ❑ Dispenser Containment Float(s) and Chain(s) Dispenser # : 5 =6 Dispenser # : 7 =8 0 Dispenser Containment Sensor(s) Model : 0794380 -208 0 Dispenser Containment Sensor(s) Model : 0794380 -208 ❑ Shear Valves ❑ Shear Valves ❑ Dispenser Containment Float(s) and Chain (s) ❑ Dispenser Containment Float(s) and Chain (s ) Dispenser # : Dispenser # : ❑ Dispenser Containment Sensor(s) Model : ❑ Dispenser Containment Sensor(s) Model : ❑ Shear Valves ❑ Shear Valves ❑ Dispenser Containment Float(s ) and Chain (s) ❑ Dispenser Containment Float(s) and Chain(s) C . CERTIFICATION 1 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 th layout of monitoring equipment. For any equipment capable of generating such reports , I have also attached a copy of the report; (check all that apply ■ System set-up ■ Alarm History Report LTON Signature : WAENGINEERING, INC. Technician / Cert M Scott Beall / B45116 8319310 Date : December* 6, 2017 © 2017 Walton Engineering , Inc.