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MONITODING SYSTEM CERTIF ATION CERTIFICATION /TEST DATE: October 30, 2012 A1. FACILITY A2. OWNER Name Ramos Oil #4376 Name Ramos Oil Address 10842 S. Harlan Road, French Camp, CA 95231 Address 1515 South River Road, West Sacramento, CA 95691 Phone # 800-477-7266 x 244 Phone # 916-371-2570 Contact Sam Delgado Contact Dave Nelson F. IN -TANK GAUGING / SIR EQUIPMENT: ■ Check this box if tank gauging is used only for inventory control. ❑ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in -tank gaugung equipment is used to perform leak detection monitoring. Complete the following checklist: ❑ Yes ❑ No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? ❑ Yes ❑ No* Were all tank gauging probes visually Inspected for damage and residue buildup? ❑ Yes ❑ No* Was accuracy of system product level readings tested? ❑ Yes ❑ No* Was accuracy of system water level readings tested? LCI Yes ❑ No * Were all probes reinstalled properly? ❑ No* Yes C1No* ■ N/A - — — - Were all items on the equipment manufacturer's maintenance checklist completed? * In Section H below, describe how and when these deficiencies were or will be corrected. IG. LINE LEAK DETECTORS (LLD): ❑ Check this box If LLDs are not installed. Complete the following checklist: * In Section H below, describe how and when these deficiencies were or will be corrected. Page 3 of 3 ■ Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? ❑ N/A (check all that apply) Simulated leak rate: ■ 3 g.p.h.; ❑ 0.1 g.p.h.; ❑ 0.2 g.p.h. Yes ❑ No* ■ Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? Was the testing apparatus properly calibrated? ■ Yes ❑ No. For mechanical LLDs, does the LLD restrict product flow if it detects a leak? [I N/A - ❑ Yes ElNo* - - - - For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ■ N/A ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled ■ N/A or disconnected? ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions ■ N/A or fails a test? ❑ Yes ❑ No* For electronic LLDs, have all accessible wiring connections been visually inspected? ■ N/A ■ Yes ❑ No* Wereall items on the equipment manufacturer's maintenance checklist completed? * In Section H below, describe how and when these deficiencies were or will be corrected. Page 3 of 3