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MONITORING SYSTEM CERTI CERTIFICATION / TEST DATE: Al. FACILITY Name Colonial Energy #40135 Address 192 Lathrop Road, Lathrop, CA 95330 Phone # 209-858-4998 Contact Station Manager F. IN -TANK GAUGING / SIR EQUIPMENT: RECEIVE TION JAN 04 2016 17, 2015 A2. OWNER I I V EZ Name Colonial Energy, LLC. 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 for ground faults? ❑ Yes ❑ No' Were all tank gauging probes visually Inspected for damage and residue buildup? ❑ Yes ❑ No' Was accuracy of system product level readings tested? ❑ Yes ❑ No' Was accuracy of system water level readings tested? ❑ ❑ Yes Yes ❑ ❑ No . No • Were all probes reinstalled property? 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. LINE LEAK DETECTORS (LLD): Complete the following checklist: ❑ Check this box if LLDs are not installed. In Section H below, describe how and when these deficiencies 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 all that apply) Simulated leak rare: ■ 3 g.p.h.; ❑ 0.1 g.p.h.; ❑ 0.2 g.p.h. ■ Yes ❑ No' Were all LLDs confirmed operational and accurate within regulatory requirements? ■ Yes ❑ No' Was the testing apparatus properly calibrated? ❑ Yes ❑ ■ NO' WA For mechanical LLDs, does the LLD restrict product flow if it detects a leak? For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ■ Yes ❑ No' ❑ WA ■ Yes ❑ ❑ No' WA For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system Is disabled or disconnected? ■ Yes ❑ ❑ 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? Were all Items on the equipment manufacturer's maintenance checklist completed? ■ Yes ❑ No' In Section H below, describe how and when these deficiencies were or will be corrected. H. COMMENTS Page 3 of 3