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MONITGRING SYSTEM CERTIF CERTIFICATION / TEST DATE: Al. FACILITY Name Colonial Energy #40135 Address 192 Lathrop Road, Lathrop, CA 95330 Phone # 209-858-4998 Contact Station Manager IN -TANK GAUGING / SIR EQUIPMENT: TION 2016 JAN 11 20io A2. OWNER -'mIE'i191pAir Ns''r. Name Colonial Energy, LLC. LIMAI-ru nr_oa�sxr.rcnt- Address 2860 N. Santiago Blvd. 2nd Floor, Orange, CA 92867 Phone # 714-761-5426 Contact Victor Hassan ■ Check this box if tank gauging is used only for inventory control. ❑ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in -tank gaugung equipment is used to perform leak detection monitoring. Complete the following checklist: ❑ Yes ❑ No' Has all Input wiring been inspected for proper entry and termination, including testing k ❑ Yes ❑ No' Were all tank gauging probes visually Inspected for damage and residue buildup? ❑ Yes EYNo' ❑ No' ■ N/A Was accuracy of system product level readings tested? _ ❑ Yas ❑ No' Was accuracy of system water level readings tested? ❑ ❑ Yes Yes ❑ ❑ No' No' Were all probes reinstalled properly? Were all items on the equipment manufacturer's maintenance checklist completed? ' In Section H below, describe how and when these deficiencies were or will be corrected. IG. LINE LEAK DETECTORS (LLD): ❑ Check this box if LLDs are not installed. Complete the following checklist: ,,, �.,..,, n uoiuw, ueacnue now ane widen mese eenclencies were or will be corrected. H. COMMENTS Page 3 of 3 ■ Yes ❑ No • ❑ N/A For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (check al/ that apply) Simulated leak rate: ■ 3g,p.h.; ❑ 0.1 g.p.h.; ❑ 0.2g.p.h. ■ Yes ❑ No . Were all LLDs confirmed operational and accurate within regulatory requirements? ■ Yes ❑ No • Was the testing apparatus properly calibrated? ❑ Yes ❑ No' ■ N/A For mechanical LLDs, does the LLD restrict product flow if It detects a leak? ■ Yes ❑ No ` ❑ N/A For electronic LLDs, does the turbine automatically shut off If the LLD detects a leak? ■ Yes ❑ No' ❑ N/A For electronic LLDs, does the turbine automatically shut off If any portion of the monitoring system Is disabled or disconnected? ■ Yea ❑ No' ❑ N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? ■ Yes ❑ No • ❑ N/A For electronic LLDs, have all accessible wiring connections been visually Inspected? ■ Yes ❑ No ` Were all items on the equipment manufacturer's maintenance checklist completed? ,,, �.,..,, n uoiuw, ueacnue now ane widen mese eenclencies were or will be corrected. H. COMMENTS Page 3 of 3