Laserfiche WebLink
f 0 <br /> Alltech Petro Inc. <br /> 17759 Buttercup Circle, Sonora, CA 95370 <br /> Phone: 209-532-7320; Fax: 209-533-2650 <br /> California Contractor 623541 A-Haz <br /> alltechmail@mac.com Fi I <br /> MONITORING SYSTEM CERTIFICATION <br /> A. General Information <br /> Facility Name:Hammer I-5 Arco Date of Testing/Servicing: August 18.2008 <br /> Facility Address:3250 Hammer Lane,Stockton CA 95209 <br /> Facility Contact Person:Wes Parkinson Contact Phone No.: 474-9125 <br /> Regulatory agency: San Joaquin Health;Inspector: ;Phone:468-9847;Fax 468-3433 <br /> Make/Model of Monitoring System: Veeder-Root TLS-350 <br /> B. Inventory of E ui ment Tested/Certified: <br /> Tank ID:87A Tank ID:87B <br /> ®In-Tank Gauging Probe. Model:Mag 1 ®In-Tank Gauging Probe. Model:Mag 1 <br /> ®Annular Space or Vault Sensor. Model:794390409 ®Annular Space or Vault Sensor. Model:794390-409 <br /> ®Piping Sump Sensor(s). Model:794380-208 ®Piping Sump Sensor(s). Model:794380-208 <br /> ❑Fill Sump Sensor(s). Model:NONE ❑Fill Sump Sensor(s). Model:NONE <br /> ®Mechanical Line Leak Detector. Model:Red Jacket ❑Mechanical Line Leak Detector. Model:Shared <br /> ❑Electronic Line Leak Detector. Model:NONE ❑Electronic Line Leak Detector. Model:NONE <br /> ®Tank Overfill/High-Level Sensor. Model:Drop Tube ®Tank Overfill/High-Level Sensor. Model:Drop Tube <br /> ®Fills ill buckets tested ®Pass ❑Fail ®Fills ill buckets tested ®Pass E]Fail <br /> Tank ID:91 Tank ID: <br /> ®In-Tank Gauging Probe. Model:Mag 1 ❑In-Tank Gauging Probe. Model: <br /> ®Annular Space or Vault Sensor. Model:794390-409 ❑Annular Space or Vault Sensor. Model: <br /> ®Piping Sump Sensor(s). Model:794380-208 ❑Piping Sump Sensor(s). Model: <br /> ❑Fill Sump Sensor(s). Model:NONE ❑Fill Sump Sensor(s). Model: <br /> ®Mechanical Line Leak Detector. Model:FE Petro ❑Mechanical Line Leak Detector. Model: <br /> ❑Electronic Line Leak Detector. Model:NONE ❑Electronic Line Leak Detector. Model: <br /> ®Tank Overfill/High-Level Sensor. Model:Drop Tube ❑Tank Overfill/High-Level Sensor. Model: <br /> ®Fills ill buckets tested ®Pass ❑Fail ❑Fills ill buckets tested []Pass ❑Fail <br /> Vapor Condensate Sump: 1&2 ®Dry❑Water[]Product Piping Transition Sump:3&4 ®Dry❑Water[]Product <br /> ® Sensor(s). Model:794380-208 ® Sensor(s). Model:794380-208 <br /> Dispenser ID: l&2®Sump:®Dry❑Water❑Product Dispenser ID:3&4®Sump:®Dry❑Water❑Product <br /> ®Dispenser Containment Sensor(s). Model:Bravo Box ®Dispenser Containment Sensor(s). Model:Bravo Box <br /> ®Shear Valve(s) (Functional test) ®Shear Valve(s) (Functional test) <br /> ® <br /> Dispenser Containment Floats and Chain (s). ®Dispenser Containment Floats and Chain (s). <br /> Dispenser ID:5&6®Sump:®Dry❑Water❑Product Dispenser ID: 7&8®Sump:®Dry❑Water❑Product <br /> ®Dispenser Containment Sensor(s). Model: ®Dispenser Containment Sensor(s). Model: <br /> ®Shear Valve(s) (Functional test) ®Shear Valve(s) (Functional test) <br /> ® <br /> Dispenser Containment Floats and Chain(s). ®Dispenser Containment Floats and Chain(s). <br /> C. Certification - I certify that the equipment identified in this document was inspected/serviced in accordance with the <br /> manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to veri that this <br /> information is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generi ting such <br /> reports,I have also attached a copy of the report;(check all that apply): ❑ System set-up ❑Alarm history repot t <br /> do <br /> Signature of Technician: Date: 8/18/2008 <br /> ,Certification:; ICC UST Technician#8005930-UT. Expires:6/14/2010 <br /> Veeder Root#B36878 ISD Expires: 8/14/2010 <br />