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,r ■ <br /> TAIT Environmental Systems <br /> cfiera:Czrntractars - -'+Lic �.C98 <br /> U.S.T. & A.S.T. MONITOR CERTIFICATION FORM <br /> Testing Date: 8/4/99 <br /> Site Location: PACIFIC BELL Tank ID(s): 2029. <br /> 4051 NEWTON ROAD CLLC Code: SKTNCAI 6 <br /> STOCKTON Geo Parcel. UE-R47 <br /> County: SAN JOAQUIN Site Contact: CLIFF EDSON <br /> Site Contact Phone#: {209) 529-0001 <br /> Make & Model of Monitor System(s): VEEDR-ROOT TLS-350 <br /> Tank 1 Tank 2 Tank 3 Tank 4 <br /> Tank ID # 2029 <br /> Type of Tank:. (Single Wall or Double Wall) UST or AST DW/UST <br /> Contents of Tank: UNLEADED <br /> Capacity of Tank: 10,000 <br /> Type of Product Line: (Gravity, Suction, Pressure) SUCTION <br /> Type of Piping: (Single Wall or Double Wall) DW <br /> INDICATE THE SENSORS TESTED BY PLACING A YES, NO, OR N/A& PASS OR FAIL IN <br /> CORRESPONDING BOX: <br /> Tank I Tank 2 Tank 3 Tank d Sensor Type <br /> Annular Space Sensor. YES PASS <br /> Fill Sump Sensor. YES PASS <br /> Piping Sump Sensor. YES PASS <br /> Piping Trench Sensor. N/A <br /> Dispenser Containment Sensor. YES PASS <br /> Pro6lems Systam(s) <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 Down Occur if Monitor System is turned off?: <br /> Is Tank Level Gauging System Present. Probe Type if Applicable. MAG <br /> Type of In-Tank Leak Detection Test Performed by Monitor. .2 GPH DAILY <br /> Does the Monitoring System have Audible &Visual Alarms? YES <br /> Electronic Overfill/Level: 90% <br /> Is the Monitoring System installed to prevent unauthorized tampering?: YES <br /> Is the Monitoring Devices operable as per manufacture's specifications? YES <br /> Date: 8/4/99 Technician: BRANDON HAM <br /> (Pri Name '1 <br /> Certified Tester's ID #: 39-3435 may} <br /> (Signature) <br /> 701 Norm Parxcenter Drive • Santa Ana, California 92705 • {7141 560-8222 (714)560-8237 fax <br /> Reg:cnal Offices: San Diego • Concord • Sacramento • Phoenix Tucson <br /> www.TAIT.com <br />