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MONIT(SING SYSTEM CERTIFWATION MAKE / MODEL OF MONITORING SYSTEM: Veeder-Root TLS-350 CERTIFICATION / TEST DATE: February 29, 2008 Al. FACILITY A2. OWNER Name 7-Eleven Market#2368/Store#32190 Name 7-Eleven, Inc Address 4943 South State Route 99,Stockton,CA 95206 Address P.O. Box 711, Dallas,TX 75221 Phone# 209-939-0679 Phone# 805-523-2949 Contact Jay Stemley Contact Shane Partridge A3. C U P A A4. TESTING CONTRACTOR Name San Joaquin County Environmental Health Name Walton Engineering, Inc. Address 600 E. Main Street,Stockton,CA 95202 Address P.O. Box 1025,W.Sacramento, CA 95691 Notified February 26,2008 Lic# 617238 A,B, Haz Inspector Muniappa Naidu Contact Richard Walton Phone# 209-468-3439 Phone# 916-825-3203 B. INVENTORY OF EQUIPMENT TESTED/CERTIFIED (Check the appropriate boxes to indicate equipment inspected/serviced) B1: TANKS Tank#1 (Product): Gasoline-87 Tank#2 (Product): Gasoline-89 ■ In-Tank Gauging Probe Model: 0846390-107 ■ In-Tank Gauging Probe Model: 0846390-107 ■ Annular Spate orVault Sensor Model: 0794380-303 ■ Annular Space or Vault Sensor Model: 0794380-303 ■ Piping Sump I Trench Sensoria) Model: 0794380-208 ■ Piping Sump/Trench Sensor(s) Model: 0794380-208 ■ Fill Sump Sensors) Model: 0794380-208 ■ Fill Sump Sensoria) Model: 0794380-208 ❑ Mechanical Line Leak Detector Model: ❑ Mechanical Line Leak Detector Model: ■ Electronic Line Leak Detector Model: 0848480-001 ■ Electronic Line Leak Detector Model: 0848480-001 ❑ 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): Gasoline-91 Tank#4 (Product): _ ■ In-Tank Gauging Probe Model: 0846390-107 ❑ In-Tank Gauging Probe Model: ■ Annular Space or Vault Sensor Model: 0794380-303 ❑ Annular Space or Vault Sensor Model: ■ Piping Sump I Trench Sensor(s) Model: 0794380-208 ❑ Piping Sump/Trench Sensors) Model: ■ Fill Sump Sensors) Model; 0794380-208 ❑ Fill Sump Sensoria) Model: ❑ Mechanical Line Leak Detector Model: ❑ Mechanical Line Leak Detector Model: ■ Electronic Line Leak Detector Model: 0848480-001 ❑ Electronic Line Leak Detector Model: ❑ Tank Overfill/High-Level Sensor Model: ❑ Tank Overfill I High-Level Sensor Model: ❑ Other (specify equipment in Section E) Model: ❑ Other (specify equipment in Section E) Model: 82: DISPENSERS/UDC's Dispenser#: 1-2 Dispenser#: 3-4 ■ Dispenser Containment Sensor(s) Model: 0794380-208 ■ Dispenser Containment Sensors) Model: 0794380-208 ❑ Shear Valves ❑ Shear Valves ❑ Dispenser Containment Float(s)and Chain(s) ❑ Dispenser Containment Float(s)and Chaln(s) Dispenser#: 5-6 Dispenser#: 7-8 ■ Dispenser Containment Sensor(s) Model: 0794380-206 ■ Dispenser Containment Sensors) Model: 0794380-208 ❑ Shear Valves ❑ Shear Valves ❑ Dispenser Containment Float(s)and Chaln(s) ❑ Dispenser Containment Float(s)and Chain(s) Dispenser#: 9-10 Dispenser#: 11-12 ■ Dispenser Containment Sensor(s) Model: 0794380-208 ■ Dispenser Containment Sensors) Model: 0794380-208 ❑ Sheaf Valves ❑ Shear Valves ❑ Dispenser Containment Float(s)and Chain(s) ❑ Dispenser Containment Float(s)and Chain(s) C. CERTIFICATION I 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 verity that this information is correct and a Plot Plan showing the 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 WALTON ____ ._.. Signature: &GINEERING,INC. Technician/Cert M Bmce N.Stewart/A31131 5249892-UT Date: February 29, 2008 0 2006 Walton Engineering,Inc.