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MONITORING SYST4VA CERTIFICATION - image 1 Continuation MAKE / MODEL OF MONITORING SYSTEM: Gilbarco EMC CERTIFICATION /TEST DATE: November 30, 2006 Al. FACILITY A2. OWNER Name Nella Oil#427 Name Nella Oil Company, LLC Address 3300 Waterloo Road,Stockton,CA 95205 Address 2360 Lindbergh Street,Auburn, CA 95602 Phone# 530-885-0401 Phone# 530-885-0401 Contact Amanda Massey Contact Amanda Massey B. INVENTORY OF EQUIPMENT TESTED/CERTIFIED (Check the appropriate boxes to Indicate equipment Inspected/serviced) B1 (Continued): TANKS Tank#5 (Product): Tank#6 (Product): ❑ In-Tank Gauging Probe Model: ❑ In-Tank Gauging Probe Model: _ I ❑ Annular Space or Vault Sensor Model: ❑ Annular Space or Vault Sensor Model: ❑ Piping Sump/Trench Sensor(s) Model: ❑ Piping Sump/Trench Sensor(s) Model: ❑ Fill Sump Sensors) Model: ❑ Fill Sump Sensor(s) Model: ❑ Mechanical Line Leak Detector Model: ❑ Mechanical Line Leak Detector Model: ❑ Electronic Line Leak Detector Model: ❑ Electronic Line Leak Detector Model: ❑ Tank Overfill/High-Level Sensor Model: ❑ Tank Overfill/High-Level Sensor Model: El Other (specify equipment in Section E) Model: ❑ Other (specify equipment in Section E) Model: Tank#7 (Product): Tank#8 (Product): _ ❑ In-Tank Gauging Probe Model: ❑ In-Tank Gauging Probe Model: I ❑ Annular Space or Vault Sensor Model: ❑ Annular Space or Vault Sensor Model: El Piping Sump/Trench Sensor(s) Model: ❑ Piping Sump I Trench Sensor(s) Model: ❑ Fill Sump Sensor(s) Model: ❑ Fill Sump Sensor(s) Model: I ❑ Mechanical Line Leak Detector Model: ❑ Mechanical Line Leak Detector Model: ❑ Electronic Line Leak Detector Model: ❑ Electronic Line Leak Detector Model: ❑ Tank Overfill/High-Level Sensor Model: ❑ Tank Overfill/High-Level Sensor Model: ❑ Other (specify equipment in Section E) Model: ❑ Other (specify equipment in Section E) Model: B2: (Continued) DISPENSERS/UDC's Dispenser#: 9-10 Dispenser#: 11-12 ❑ Dispenser Containment Sensor(s) Model: ❑ Dispenser Containment Sensor(s) Model: ■ Shear Valves ■ Shear Valves ■ Dispenser Containment Float(s)and Chain(s) ■ Dispenser Containment Float(s)and Chain(s) Dispenser#: - _ -- Dispenser# - ❑ Dispenser Containment Sensor(s) Model: ❑ Dispenser Containment Sensor(s) Model: ❑ Shear Valves ❑ Shear Valves ❑ Dispenser Containment Float(s)and Chain(s) ❑ Dispenser Containment Float(s)and Chain(s) Dispenser#: Dispenser# ❑ Dispenser Containment Sensor(s) Model: ❑ Dispenser Containment Sensor(s) Model: ❑ Shear Valves ❑ Shear Valves ❑ Dispenser Containment Float(s)and Chain(s) ❑ Dispenser Containment Float(s)and Chaln(s) Dispenser#: Dispenser# ❑ Dispenser Containment Sensor(s) Model: ❑ Dispenser Containment Sensor(s) Model: ❑ Shear Valves ❑ Shear Valves ❑ Dispenser Containment Float(s)and Chain(s) ❑ Dispenser Containment Float(s)and Chain(s) — enser ❑spDispenser Containment Sensor(s) Model: - J ❑s Despenser Containment Sensor(s) Model: ❑ Shear Valves ❑ Shear Valves ❑ Dispenser Containment Float(s)and Chain(s) ❑ Dispenser Containment Float(s)and Chain(s) Dispenser#: Dispenser# i ❑ Dispenser Containment Sensor(s) Model: i ❑ Dispenser Containment Sensor(s) Model: P � El Shear Valves El Shear Valves El Dispenser Containment Floats and Chains ❑ Dispenser Containment Float(s)and Chain(s) ©2006 Walton Engineering,Inc. Page la of 3