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0 • <br />ZNTTAIT Environmental Systems <br />General Contractors - CA Lic. #588098 <br />U.S.T. & A.S.T. MONITOR CERTIFICATION FORM <br />Site Location: PACIFIC BELL <br />County: <br />12TH STREET <br />TRACY <br />SAN JOAOUIN <br />Make & Model of Monitor System(s): <br />Testing Date: 8/6/99 <br />Tank ID(s): <br />1103 <br />_ <br />CLLC Code: <br />TRACCAI I <br />Geo Parcel: <br />UE -058 <br />Site Contact. <br />KEN MCDONALD <br />Site Contact Phone #: (209) 9A3 -A128 <br />V F E D E R -ROOT TLS3 50 <br />UDIESEL <br />Tank ID # <br />Type of Tank: (Single Wall or Double Wall) UST or AST <br />Contents of Tank Capacity of Tank: Type of Product Line: (Gravity, Suction, Pressure) Type of Piping: (Single Wall or Double Wall) <br />INDICATE THE SENSORS TESTED BY PLACING A YES, NO, OR N/A & PASS OR FAIL IN <br />CORRESPONDING BOX: <br />Annular Space Sensor. <br />Fill Sump Sensor. <br />Piping Sump Sensor. <br />Piping Trench Sensor. <br />Dispenser Containment Sensor. <br />Problems System(s) <br />Tank A <br />Tank 1 Tank 2 Tank 3 Tank A Sensor T e <br />YES PASS <br />YES PASS <br />YES PASS <br />FOR PRESSURE TYPE SYSTEMS ONLY: <br />Tank 1 Tank 2 Tank 3 Tank A <br />Is Mechanical Line Leak Detector Present 8t Tested?: <br />Does the Turbine Shut -Down if System Detects a Leak?: <br />Does Positive Shut Down Occur if Monitor System is turned off?: <br />Is Tank Level Gauging System Present. Probe Type if Applicable. MAG <br />2 GPH DAILY <br />Type of In -Tank Leak Detection Teat Performed by Monitor. <br />Does the Monitoring System have Audible & Visual Alarms? YES YES <br />Electronic Overfill/Level: <br />Is the Monitoring System installed to prevent unauthorized tampering?: YES <br />Is the Monitoring Devices operable as per manufacture's specifications? YES <br />Date: 8/6/99 Technician: BRANDON HAM <br />(P "ntA <br />Certified Tester's ID #: 393A35 � <br />(Signature) <br />701 North Parkcenter Drive • Santa Ana, California 92705 • (714) 560-8222 (714) 560-8237 fax <br />Regional Offices, San Diego • Concord • Sacramento • Phoenix • Tucson <br />ww .TAIT.com <br />