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I -WRING SYSTEM CERTOCATION CERTIFICATION /TEST DATE: January7 2015 Al. FACILITY A2. OWNER Name Tower Mart # 104 Name Tower Energy Group, Inc. Address 192 Lathrop Road, Lathrop, CA 95330 Phone # 209-858-4998 Address 1983 West 190th Street, Torrance, CA 90504 Phone # 916-285-7402 ext 100 Contact Desiz Burns Contact Mark Vasey F. IN -TANK GAUGING / SIR EQUIPMENT: ■ 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: FYesYes ❑ 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 ❑ No' Were all probes reinstalled properly? ❑ Yes ❑ No' Were all Items on the equipment manufacturers maintenance checklist completed? In Section H below, describe how and when these deficiencies were or will be corrected. G. LINE LEAK DETECTORS (LLD): ❑ Check this box if LLDs are not installed. Complete the following checklist: ■ Yes ❑ No' For equipment start-up or annual equipment certification, was a leak simulated to verily LLD performance? ❑ N/A (Cheek all that apply) Simulated leak rate: ■ 3 g.p.h.; ❑ 0.1 g.p.h.; ❑ 0.2 g.p.h. ■ Yes ❑ No' Were ail LLDs confirmed operational and accurate within regulatory requirements? .. ■ Yes ❑ No' Was the testing apparatus properly calibrated? ❑ Yes ❑ No' For mechanical LLDs, does the LLD restrict product flow If It detects a leak? ■ NIA ■ Yes ❑ No' For electronic LLDs, does the turbine automatically shut off H the LLD detects a leak? ❑ NIA ■ Yes ❑ No' For electronic LLDs, does the turbine automatically shut off If any portion of the monitoring system Is disabled ❑ N/A or disconnected? ■ Yes ❑ No" For electronic LLDs, does the turbine automatically shut off H any portion of the monitoring system malfunctions ❑ WA or falls a test? ■ Yes ❑ No' For electronic LLDs, have all accessible wiring connections been visually Inspected? ❑ NIA i, ■ Yes ❑ No' Were all Items on the equipment manufacturers maintenance checklist completed? ' In Section H below, describe how and when these deficiencies were or will be corrected. H. COMMENTS 87-1 and 87-2 are line manifolded with a single ELLD. Page 3 of 3