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MONIT' 'RING SYSTEM CERW CATION CERTIFICATION / TEST DATE: Au ust 12, 2013 Al. FACILITY A2. OWNER Name 7-Eleven Market#2368/Store#17334 Name 7-Eleven, Inc Address 4501 North Pershing Street,Stockton,CA 95207 Address P.O. Box 711, Dallas,TX 75221 Phone# 209-951-6745 Phone# 805-523-2949 Contact Stephen Boyd contact Stephen Boyd 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: ❑ Yes ❑ No' Has all Input wiring been Inspected for proper entry and termination,Including testing for ground faults? ❑ Yes ❑ No• I Were all tank gauging probes visually Inspected for damage and residue buildup? ❑ Yes ❑ No• Was accuracy of system product level readings tested? ❑ Yes ❑ Noe Was accuracy of system water level readings tested? ❑ Yes ❑ No• Were all probes reinstalled properly? L ❑ Yes ❑ No' Were all Items on the equipment manufacturer's maintenance checklist completed? f — _ ' 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 verity LLD performance? ❑ WA (check all brat apply) Simulated leak rate: ■ 9 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? ❑ Yea ❑ Noe Was the testing apparatus properly calibrated? ❑ Yes ❑ No For mechanical LLD$,does the LLD restrict product flow H It detects a leak? [I WA ❑ Yes ❑ Yes ❑ No• For electronic LLDs,does the turbine automatically aumautomaticallyshut off ti the LLD detectsa laak7 ❑ WA •❑ l For electronic LLDs,does the turbine automatically shut off If any portion of the monitoring system Is disabled ❑ WA or disconnected? 13 Yea ❑ Noe For electronic LLDs,does the turbine automatically shut oft H arty portion of the monitoring system malfunctions _ ❑ WA or falls a test? ❑ Yes ❑ No' For electronic LLOs,have all accessible wiring connections been visually Inspected? ❑ NIA ❑ Yes ❑ No' 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. H. COMMENTS ',2013 Walton Engineering,Inc. Page 3 of 3