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MONITCOING SYSTEM CERTIF ATION CERTIFICATION /TEST DATE: October 30, 2012 A1. FACILITY ■ No* A2. OWNER ❑ Yes Name Ramos Oil #4376 ❑ Yes Name Ramos Oil Address 10842 S. Harlan Road, French Camp, CA 95231 Were all sensors installed at lowest point of so( Address 1515 South River Road, West Sacramento, CA 95691 Phone # 800-477-7266 x 244 ❑ No* Phone # 916-371-2570 Contact Sam Delgado ❑ Yes Contact Dave Nelson D. RESULTS OF TESTING / SERVICING Make / Model of Monitoring System: Incon TS -1000 Software Version Installed: 0.75 Complete the following checklist: ❑ Yes ■ No* Is the audible alarm operational? ❑ Yes ■ No* Is the visual alarm operational? ❑ Yes IN No * Were all sensors visually inspected, functional) ■ Yes ❑ No* Were all sensors installed at lowest point of so( will not interfere with their proper operation? ❑ Yes ❑ No* If alarms are relayed to a remote monitoring sta ■ N/A operational? ❑ Yes ■ No* For pressurized piping systems, does the turbir ❑ N/A monitoring system detects a leak, fails to opera positive shutdown? (check all that apply) ■ S ❑ Yes ■ No * Did you confirm positive shut -down due to leaks ❑ Yes ❑ No* For tank systems that utilize the monitoring sys ■ N/A mechanical overfill prevention valve is installed fill point(s) and operating properly? If so, at wh ❑ Yes * ■ No Was any monitoring equipment replaced? If ye: and list the manufacturer name and model for al ElYes * ■ No Was any liquid found inside any secondary coni (Check all that apply) ❑ Product; ❑ Water. 11 ■ Yes ❑ No * Was monitoring system set-up reviewed to insu ElYes , ■ No* Is all monitoring equipment operational per man - In section t below, describe how and when these deficiencies were or will be corrected. E. COMMENTS Audible and visual alarms not functioning. Site closed until problem is fixed. Page 2 of 3