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MONITOR CERTIFICATION FORM <br /> CUSTOMER: THE SOUTHLAND CORPORATIOSITE I.D.: 7-ELEVEN#20632 DATE: 09/25/96 <br /> ADDRESS: -MARKET 2235 <br /> 4627 DA VINCI DR WORK ORDER: 966563 <br /> STOCKTON, CA 95207 <br /> 1) IN TANK PROBES <br /> MANUFACTURER: TIDEL MODEL NUMBER: EMS2000 <br /> SERIAL NUMBER: NUMBER OF TANKS MONITORED: 3 <br /> SET UP FOR MONTHLY TESTY/N): YES LAST TEST DATE: 09/20/96 <br /> PASSED/FAILED?: PASSED <br /> DOES THE SYSTEM DISPLAY OR PRINT <br /> OUT MONTHLY TEST RESULTS (Y/N): YES TYPE(DISPLAY OR PRINT OUT): PRINT OUT <br /> OPERATIONAL(Y/N): YES <br /> COMMENTS: <br /> 2)OTHER PROBES: MANUFACTURER: MODEL: <br /> NUMBER OF LIQUID, FLOT.SW., POSITIVE SHUT FAIL SAFE(Y/N) OPERATIONAL <br /> PROBE LOCATION PROBES OR VAPOR SENSOR DOWN(Y/N) <br /> ANNULAR PROBE 0 <br /> TURBINE SUMP 0 <br /> FILL SUMP 0 <br /> FIBERTRENCH 0 <br /> MONITORING WELL 0 <br /> DISPENSER PAN 0 <br /> OTHER 0 <br /> ANNULAR SPACE FILLED WITH MONITORING FLUID?: <br /> COMMENTS: <br /> PAGE 1 OF 2 <br />