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4 <br />DIALYSIS <br />P.O. BOX 3178 * 3IMI VALLEY, CA 93093 <br />• <br />CERTIFIED <br />TANK TESTING <br />TANK CLEANING <br />MONITOR CERTIFICATION <br />U.S. T. MONITORING EQUIPMENT <br />INSPECTION REPORT <br />*** IMPORTANT DOCUMENT *** <br />YOUR LOCAL REGULATORY AGENCY WILL REQUEST TO VIEW THIS <br />CERTIFICATE, PLEASE KEEP A COPY AT THE FACILITY. <br />COMPANY NAME: Pacific Bell <br />LOCATION: LODICA01 <br />UE -020 \ # 795 <br />124 W. Elm Street <br />Lodi, CA 95240 <br />n= <br />800-227-7879 <br />805-520-4858 <br />FAX 805-527-3854 <br />On Thursday August, 29 1996, Dialysis Company, an authorized service representative of Veeder- <br />Root Environmental Products, certified one TLS250i console, on an Underground Storage Tank <br />System. Serial Number # 22065. <br />The following items were tested individually and found to be in working order: <br />Annular Space Sensor(s):1 Float <br />Liquid Sump Sensor(s): 2 Float <br />TLM Probe(s): 1 Cap <br />Alarm Simulation: High / Low, Pass <br />Tank Type(s):1/4,000 Diesel, Double Wall UST & Line. Suction <br />Comments: Panel, probe and sensors were found to be fimctioning as per manufactures <br />specifications. No testing required at this time. Double wall Tank and line. Cleaned the overspill <br />well and sump. Suction system. <br />The alarm panel was tagged with a Dialysis Company Seal. <br />SIGNED BY: <br />Tamara Zimmerman, O <br />f <br />