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MONITURING SYSTEM CERTIFMATION <br />CERTIFICATION /TEST DATE: September 2, 2014 <br />Al. FACILITY <br />❑ No* <br />Is the audible alarm operational? <br />A2. OWNER <br />❑ No * <br />Name <br />7 -Eleven Market #2369 / Store #35355 <br />❑ No * <br />Name <br />7 -Eleven, Inc <br />Address <br />3202 W. Hammer Lane, Stockton, CA 95209 <br />Address <br />P.O. Box 711, Dallas, TX 75221 <br />Phone # <br />209-957-2900 <br />If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modems) <br />Phone # <br />805-523-2949 <br />Contact <br />Stephen Boyd <br />❑ No * <br />Contact <br />Stephen Boyd <br />D. RESULTS OF TESTING / SERVICING <br />Make / Model of Monitoring System: Veeder-Root TLS -350 <br />Software Version Installed: 332.00 <br />Complete the following checklist: <br />■ Yes <br />❑ No* <br />Is the audible alarm operational? <br />■ Yes <br />❑ No * <br />Is the visual alarm operational? <br />■ Yes <br />❑ No * <br />Were all sensors visually inspected, functionally tested, and confirmed operational? <br />■ Yes <br />❑ No* <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment <br />will not interfere with their proper operation? <br />■ Yes <br />❑ No* <br />If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modems) <br />❑ N/A <br />operational? <br />■ Yes <br />❑ No * <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br />❑ N/A <br />monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate <br />positive shutdown? (check all that apply) ■ Sumplrrench sensors; ■ Dispenser Containment Sensors. <br />■ Yes <br />❑ No* <br />Did you confirm positive shut -down due to leaks and sensor failureldisconnection? <br />❑ Yes <br />■ No * <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br />❑ N/A <br />mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br />fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? _ % <br />❑ Yes * <br />■ No <br />Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced <br />and list the manufacturer name and model for all replacement parts in Section E, below. <br />■ Yes * <br />❑ No <br />Was any liquid found inside any secondary containment systems designed as dry systems? <br />(Check all that apply) ■ Product; ■ Water. If yes, describe causes in Section E, below. <br />■ Yes <br />❑ No * <br />Was monitoring system set-up reviewed to insure proper settings? Attach set-up reports, if applicable. <br />■ Yes <br />❑ No * <br />Is all monitoring equipment operational per manufacturer's specifications? <br />* In Section E below, describe how and when these deficiencies were or will be corrected. <br />E. COMMENTS <br />Removed liquid from all fill sumps and disp 5-6 & 7-8. <br />The string broke on the diesel wrap around annular sensor. We removed the riser, installed a nylon rope, <br />reinstalled the riser, and put the sensor back in place. <br />The audio does not work for the external overfill alarm. Site also has flappers. <br />Monitoring plan needs to be changed to flappers, or overfill alarm needs to be replaced. <br />This is a cold start certification after repairs. <br />Page 2 of 3 <br />