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STATION ADDRESS: CITY: RIPON WIC#: 6522-0307 klyawrimigj Tank Material: [ ] Fiberglass [ X ] Steel [ ] Fibersteel Tank Type: [ X ] Single Wall [ ] Double Wall Interstitial Monitor [ Wet Dry Annular Line Material: [ ] Fiberglass [ X ] Steel [ ] Flex Line Line Type: [ X ] Single Wall [ ] Double Wall [ ] Trench Containment Waste Oil Tank Type: [ ] Single Wall [ ] Double Wall [ ] Above Ground TANK M0NTTnRTNti.qVfiTFMt'FRTTRFT)• t X1 OPERATIONAL t !, I NON -OPERATIONAL QTY TYPE POSITIVE* SHUT DOWN FAIL * SAFE OPERATIONAL MANUFACTURER MODEL NUMBER Yes No Interstitial Monitor [ Wet Dry Annular Yes No Yes No Yes No Yes No 1 Electronic Tank Level Monitor X Yes No RONAN X76ETM Yes No Vadose Monitor Yes No Yes No Yes No Yes No Fill / Vapor Recovery Riser Yes No Yes No Yes No All Monitor Visually All Underground Product Tanks Are Monitored Using Inventory Reconciliation. " Positive Shut Down and Fail Safe are NOT required under Title 23, Division 3, Chapter 16 of the California Code of Regulations. A'RTR 011. MnNITnRINCISYSTFM - C"_FRTIFMI). T 1 )PERATIONAL I' 1 NON. -OPERATIONAL QTY TYPE OPERATIONAL MANUFACTURER MODEL NUMBER MANUFACTURER MODEL NUMBER Interstitial Monitor [ 1 Wet [ ]Dry Annular Yes No X Yes No 2-XLD, I -LD -2000 Fill / Vapor Recovery Riser Yes No Yes No Yes No Monitoring Visually Inventory Reconciliation: Yes No T Tl A40N"0R1Nr. SYfiTFM rRRTIFTFT) T V 1 OPF.RATIONAI. I! 1 NON.nPFRATIONAL QTY TYPE POSITIVE SHUT DOWN FAILOPERATIONAL SAFE MANUFACTURER MODEL NUMBER 3 Mechanical Leak Detector X Yes No 2-XLD, I -LD -2000 Electronic Line Pressure Monitor Yes No Yes No Yes No Electronic Line Pressure Monitor with Mechanical Leak Detector Yes No Yes No Yes No Electronic Tank Sump Monitor Yes No Yes No Yes No Electronic Line Trench Monitor Yes No Yes No Yes No I CERTIFY THAT THE ABOVE CERTIFICATION INFORMATION IS ACCURATE AND TRUE. SIGNATURE: PRINT NAME: MIKE LEVESQUE Rev: 12/31/94 Page 1 of 3 COMPANY: NDE Environmental DATE: 03/06/95