|
AUG-26-2002 10 :26 AM GETTLER-RYAN INC. 925 551 4770 P. 03
<br /> MONITORING SYSTEM CERTIFICATION
<br /> Por(:w lit-,III Aro Still,fiolly it Whin thr' `lfrut,ot't'uli/ruvlilt
<br /> il,thrnrilt t'/hell. C.'hdlrlt v h. llvwldt t111d So11•l,l•if'illlr: l'hcriner IA. !In„r„n .l, 1711.t 73 l crldolwhl Code ol'Ri t!vIlliin)ts
<br /> 111i" f111'nl Ittua hC UNCd tit disculnvilt lasting :Intl „•rt icing tit'Illowl%whi_, ctluil,ntcnl. \ ,.h,lrut���1_Ij1iCiVi,,tt_i+r r�IJ�{1i nlua by t? {ru;vl( t�)1',yly.
<br /> 111UUtt!liil{;.��`tS!r 4tlllttti,�ttalll�l h1'the leehlliviall tthu lut ,"I.m.Ihv tti,t'k. A cult+ Ill Ilii,1'-:rlt, null he plat itied Ili the Iank fivAjk!I11 ttwlti r upennor.
<br /> 1 he tiltvner illivrator 111t1a stab li)a Copy of illi.form It,Ilie hIt-al ilL'eltcl 1-Cgtllilllllt:•('%1'st,ter).,tt Ithill ill ilih s of tC\1 dale.
<br /> A. General Information
<br /> hicilitil, Nalne: Arco AmIPm i#6020 i ldg. No.: _..._.._._,Site:address; 1711 Yosemite c.•ili. Manteca .ip: .._.___....
<br /> Facility(.i,11GtCt Person; ( oniatt ('hone tic
<br /> ----. . _..__.... - - . .._....
<br /> Make Ivfvdicl ol'Monitoring System: Veeder Root TL5350 i)me of NstinU/Servicing: .81612008._._—
<br /> B. Inventory of Equipmlent Te!Ited/C'ertified
<br /> Check the appro,riale bows to Indicate We c of meal i`mi n1ed.'scrOcedt
<br /> R..:.i':1' ./Mr7.S- ••'^-q .i.:::-'..._�.... w,.1 - R-.�.•.••s�rR3 ��”„rv.wwi.iwsualletuenrtc:nanrrvrl.siaralautr-rr•R.•r.iba[JNY.v,mw.1✓Ot'
<br /> Took ID'
<br /> in-rank Gauging l fntV. klotkl: -_---�- (� In•lun6 t)aal:nt"Pntl+:.
<br /> ❑Annalar Space or Vault SOU-Sur Mndvl ---- _---„_-.•- l� \nuuLu I-I':Icv ur Vauh ticn,nr. _-
<br /> Ij1'IpirlkSump 'tNI1011SCUMILIS)• Mt,dt•I; � — _ [� 4'ihinLSmn{• Irtnthtirn.uttc: Muriel: .r „�-
<br /> Fill Sump Sen.urt•). Model: ---- ❑ 1,111 tion))•�.n,.,r1a. Model: �,���
<br /> ['m4.v:hittlival Linc I_tuk Ocioctur. :N,nita• - Cj ItI:eh:ou„11 Int;I.Lak 1 o"inr. Model: _--
<br /> �]icJtznx,nic(.iuv 1-Oak UOltvtor. M11ndci' - - lE Ivru;,nlc I till-Leak I)t•ICtltu• Model:
<br /> junk Crxvrlill High-Level titnppr Model: - _— ❑ l:ntlt(holill I lik-h-1 vyt.•I Sena r. S1i dvk
<br /> l.�(')dterlqptclty 0.11.1ilxnlvtt11 type and Inuilvl tit twdioil Ii un IlauL.2+. [](pile)I,ltccill Ctluipnitnl iypv:u d nttulel in 5vetiun f;nn P;t1a'1
<br /> ,�,�,�,wa.n.w..mR•IlowuAOWI�I(S!-'t'!DD'1��:�•r+�:.:..C'�';•;••�-wlx=•w-�-:: -'-••wvmwf._.�y.:,^,S=G-,a+wsw�•rLlilitilC.Cf.+wwire�erk4lgYain�R.".71APwn.,w4WaF:mg91n2R^"*•rwd-d:enW�•.
<br /> leek ID: Wank ID: __—
<br /> ]�kn-Tatl6liatlglrlg Proity. --- Nlndel. - [7] tiougiug I'1•nhv. Mndcl: _-
<br /> ❑Antlulitr Space or Vaull Sensor. M,,.k•I: J- -- (_] .\anular Spav, „ Fault Senrwl Mkitli l: _
<br /> Piping Sump 1lVilch Scnvults). Model: —�_ I U Piping~tool, I rt•nt Il Si nsuti-I MkIdO,
<br /> `]Fill Slung 5ttls„tt.l. Madel: __._---_----._...----..---.---.-. rl)ill Sump S011-11141 Model:
<br /> 0 Mcxhamud Llnv Lett).(h•IC IL01'. Mudd; ��_..-_---____-• � �] lv:it;unr,l l I-e IA•,Ik l)elct nr. Model:
<br /> ❑iatvin+nic line Lwk Delts;uu', Slndvl: -� w [� I );tonal I iue l.till, (Maxtor. Model: �-
<br /> (� 'mtk(Itvrtill 1%li•L•vvelSvnsor. Modt•I:
<br /> _- (J I,ut6r1,•rldl ili�lo-l.vyvltitnn,r, Model
<br /> 1
<br /> Ulht•1•I,litelly l'tlllipr loll type anIllod"I Ill Smion F tilt 1'ItSt'�I L—M,
<br /> ["a(1111e1 •1`o-A �alatp11101(ITO:1 tet moth•)ill StYIINII{I Un 1`44k:31.
<br /> A'._i!lf7lPTDR'R �V�!�w�'�„wrwi��w w..�T.•::y.•..,. .... • -•m :::••.w._...:�i�!•+.rM/a<ro,.._<.7•.]".1,;!!�iR>a,�S.T�R3S•
<br /> Dispenser 11); 13114 _ ;{ I)hpcover 11>: 15116
<br /> ['Di.pvawrConlaiunualSvir-wil.) Model. 794380.323 -- r� th,l,:n„I t•, nl:linot,•nl!+vrt,ow I Madel: 794380423
<br /> Q Shear Valt,i.$)• L]tihvitl 1,,It,ti,I
<br /> ❑I.>iapt nwt r(lariainmvnt Flonll+)and OilliIll a.� Lrj, 01,11vmrl t"it arltnwnl I•Iu;Iti•I and Chainlsl
<br /> ...waa,necuwera-:ea.mo.. .xe:waa:'x.«.._.....,,_..,,._.�...: _r•....,:-•_.... .•-•...r.�+."�r.....�:�;; IL,.+..e...�vwrremxvev»,...r=x,wrsr•.+.�w,ca
<br /> Dispenser li): --.---
<br /> Q Ui.ptmer<'utttitinntenl Svll�ugsl. biotic): — _� _..-----.__---- _ I E�l>iq•r •. l „nl.timnrnl M'n,t n.1 Mudcl: ,.^-- ., ---
<br /> Sheur 1•ideki.,0 ]ihe•u uh:r•l,
<br /> ❑
<br /> • 1i,1„n,.l l't,al.linlu,nt FIaull,lm1dChuiut,l.Dt.prrl.ert•untatmnvnl f luultxl and t•Itaunh), l-1 I
<br /> ..wwt«aaw —.r:-�r..,...,r�.w.s:;�,.a...--- .... .._._.. -r.� ..:.::r.-..... :•.,.._.ara.o�1,.x�:'•",.•.w...a.� m�rr.
<br /> Dispenser ID:
<br /> IN,1,n.v,t ,•nl.linnl,til tivn+t,r, . Mndvl.
<br /> Disl+t•n,ri l'anlainntcnl SCI1.41114t. ML+del: —_`�•__. -.-.-, �� �-` t _---�-•�----•�~"—
<br /> '�,]tih:•ul'�:+I,d�l. I l.i`,ht•nr 1.II,t•!. .
<br /> (J I n,p:+ta l t't,rl,umnam E ln:nl. :uxl l'haiiloo,
<br /> ( ]Di,�ptat,a C ontuinniviii Floa lls)and Ch:alivo, f ........�.�:�-...... -w t-,..... ,..
<br /> '11'Ilte f:Icilil)coillatill<marclalth.ul'lli.ptnxcr,..alt\ Ilii•term. lllchtdp ullommlitgt I,•t ,,,I) Itt11l.anal tli,ltctl,er.Il IIIc litclllty.
<br /> (.
<br /> Certification -I certify that the e(Itlipntiatt illetllitied in ihin(llMllilli xsat:IIIYplclivillAerviced in stecordance with the manufacturers'
<br /> Imidellnes. ,%ttache(1 to tills Certifieution is inf-Anfli lull (e.g. manul'neturerv' checklisl!t) neckssary to veril} Thal thiii information is
<br /> correct Intl u Plot Plan show(nu the layout ur numilu,r{ns:cila{pntellr. hog not vryuipnlenl callAwle of lrenerllihl(;silch reporls,I hove also
<br /> allached a copy of the report;/rhos-A u11 that rr/r/,/,ly: :_.� ti�stltnt scl-up ( ; .Mural Illktory report
<br /> I t,'+:hnivitut NIIIIQ(print): .Mike Pratt
<br /> CerliticulitlaNo.: A29265I p.cnw �.+. 5252315-UI
<br /> fr.tim-, t ompam,N;1 iv,. Gettler.Ryan-Inc. Plit,slc No
<br /> I t•un c i,t,g1,►nV ; ddiv..: 6747 Slerra-Ct., Dublin Ca Ox': • 1 I u:Iin4� tirrt It.alt, 81f3/2t)(18
<br /> Page 1 ,II' 3
<br /> Rei. 12 0.11
<br />
|