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17AT <br />TAIT ENVIRONMENTAL SYSTEMS <br />U.S.T. & A.S.T. MONITOR CERTIFICATION FOIRM. #588098 • AZLic. #095984 <br />Testing Date: 8/5/98 <br />Site Location: PACIFIC BELL Tank ID(s): 795 <br />124 W. ELM STREET CLLC Code: LODICA01 <br />LODI Geo Parcel: UE -020 <br />County: SAN JOAQUIN Site Contact: RON STANLEE <br />Site Contact Phone #: (209) 4544560 <br />Make & Model of Monitor System(s): VEEDER-ROOT TLS -2501 <br />Tank 1 Tank 2 Tank 3 Tank 4 <br />Tank ID # 795 <br />Type of Tank: (Single Wall or Double Wall) UST or AST DW/UST <br />Contents of Tank: DIESEL <br />Capacity of Tank: 4,000 <br />Type of Product Line: (Gravity, Suction, Pressure) SUCTION <br />Type of Piping: (Single Wall or Double Wall) DW <br />INDICATE THE SENSORS TESTED BY PLACING A YES, NO, OR N/A & PASS OR FAIL IN CORRESPONDING <br />BOX: <br />Annular Space Sensor: <br />Fill Sump Sensor: <br />Piping Sump Sensor: <br />Piping Trench Sensor: <br />Dispenser Containment Sensor: <br />Problems System(s) <br />Tank 1 Tank 2 Tank 3 Tank 4 Sensor T pe <br />YES PASS <br />YES PASS <br />YES PASS <br />FOR PRESSURE TYPE SYSTEMS ONLY: <br />Tank 1 Tank 2 Tank 3 Tank 4 <br />Is Mechanical Line Leak Detector Present & Tested?: <br />Does the Turbine Shut -Down if System Detects a Leak?: <br />Does Positive Shut Down Occur if Monitor System is turned off?: <br />Is Tank Level Gauging System Present, Probe Type if Applicable. <br />Type of In -Tank Leak Detection Test Performed by Monitor: <br />Does the Monitoring System have Audible & Visual Alarms? <br />Electronic Overfill/Level: <br />Is the Monitoring System installed to prevent unauthorized tampering?: <br />Is the Monitoring Devices operable as per manufacture's specifications? <br />Date: 8/5/98 Technician: <br />Certified Tester's ID #: 569-39-3435 <br />.2 <br />YES <br />90% <br />YES <br />YES <br />BRANDON HAM <br />int Na ) L} <br />(Signature) <br />1100 Town & Country Road • Suite 1200 • Orange, CA 92868 • (714) 560-8222 • (714) 560-8211 FAX <br />Other Locations: San Diego, CA • Concord, CA • Sacramento, CA • Phoenix, AZ • Tucson, AZ <br />Established 1964 <br />