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Environmental Management P.O.Box 5095 <br /> Pacific Region Room 3E000 <br /> San Ramon,CA 94583 <br /> UST & AST MONITOR CERTIFICATION FORM <br /> Testing Date: 08-02-00 <br /> Next Due Date: 08-02-01 <br /> Site Location: PACIFIC BELL Tank ID(s): 2048, 2049 <br /> 2300 E. EIGHT MILE ROAD CLLC Code: SKTNCAB3 <br /> STOCKTON Geo Parcel: UE-708 <br /> County: SAN JOAQUIN Site Contact CONNIE MITCHELL <br /> Site Contact Phone#: 209-4744022 <br /> Make&Model of Monitor System(s): VEEDER ROOT TLS-350 <br /> Serial#of Monitor System(s): 60137044905001 <br /> Tank 1 Tank 2 Tank 3 Tank 4 <br /> Tank ID# 2048 2049 <br /> Type of Tank: (Single Wall or Double Wall) UST or AST DW-UST DW-UST <br /> Tank Material (Composit, Fiberglass,etc.) COMP COMP <br /> Contents of Tank: UNL DSL <br /> Capacity of Tank: 10074 5037 <br /> Type of Product Line: (Gravity, Suction,Pressure) SUCTION SUCTION <br /> Type of Piping: (Single Wall or Double Wall) DW DW <br /> ALLSYSTEMS Tank 1 :Tank 2 Tank 3 Tank 4 Sensor Type <br /> (Float,Discrim,etc. <br /> Annular Space Sensor: YES PASS FLOAT <br /> Fill Sump Sensor: YES PASS YES PASS DISCRIM <br /> Piping Sump Sensor: YES PASS DISCRIM <br /> Piping Trench Sensor: <br /> Dispenser Containment Sensor: YES PASS YES PASS DISCRIM <br /> Other Types(Sensors): ICompartmented Tank(s) YES <br /> Type of Overfill Protection(mechanical,electronic,bail float) MECHANICAL <br /> Type of Spill Containment(Make&Model) 5 GALLON PHILTITE <br /> FOR PRESSURE TYPE SYSTEMS ONLY <br /> Tank 1 Tank 2 Tank 3 Tank 4 <br /> Is Mechanical Line Leak Detector Present&Tested?: <br /> Does the Turbine Shut-Down if System Detects a Leak?: <br /> Does Positive Shut Doom Occur if Monitor System is turned off?: <br /> ALL SYSTEMS YES MAG.2 <br /> In-Tank Gauge Present. Probe Type and Type of Leak Detection (Ex. .2 gph). <br /> Does the Monitoring System have Audible&Visual Alarms? YES <br /> Is the Monitoring System installed to prevent unauthorized tampering?: YES <br /> Is the Monitoring Devices operable as per manufacture's specifications? YES <br /> Testing Company: TAIT ENVIRONMENTAL SYSTEMS <br /> Date: 08-02-00 Technician: BRANDON HAM <br /> (Print me) <br /> Certified Tester's ID#: 39-3435 <br /> (Signature) <br />