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MONIT4WING SYSTEM CERTI4CATI , <br />CERTIFICATION /TEST DATE: May 6, 2015 MAY 1 1 2015 <br />Al. FACILITY A2. OWNER �--NVIR NMENT ! <br />Name Quik Stop Market #120 Name Quik Stop Markets, Inca -,,.-1 , "r77A7"'A 17K <br />Address 9321 Thornton Road, Stockton, CA 95209 Address 4567 Enterprise Street, Fremont, CA 94538 <br />Phone # 510-657-8500 Phone # 510-657-8500 <br />Contact Roger Batra Contact Debbie Markovich <br />D. RESULTS OF TESTING / SERVICING <br />Make / Model of Monitoring System: Veeder-Root TLS -350 SN# 60839518705003 <br />Software Version Installed: 329.01 <br />Complete the following checklist: <br />■ Yes <br />❑ No* <br />Is the audible alarm operational? <br />Is the visual alarm operational? <br />■ Yes <br />❑ No* <br />■ Yes <br />❑ No* <br />Were all sensors visually inspected, functionally tested, and confirmed operational? <br />■ Yes <br />❑ No* <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment <br />will not interfere with their proper operation? <br />❑ Yes <br />❑ No* <br />If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modems) <br />■ N/A <br />operational? _ <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br />■ Yes <br />❑ No* <br />❑ N/A <br />monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate <br />positive shutdown? (check all that apply) ■ Sump/Trench sensors; ❑ Dispenser Containment Sensors. <br />■ Yes <br />❑ No* <br />Did you confirm positive shut -down due to leaks and sensor failure/disconnection? <br />❑ Yes <br />❑ No* <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br />■ N/A <br />mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br />fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? _ % <br />Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced <br />❑ Yes * <br />■ No <br />and list the manufacturer name and model for all replacement parts in Section E, below. <br />■ Yes * <br />❑ No <br />Was any liquid found inside any secondary containment systems designed as dry systems? <br />(Check all that apply) ❑ Product; ■ Water. If yes, describe causes in Section E, below. <br />■ Yes <br />❑ No* <br />Was monitoring system set-up reviewed to insure proper settings? Attach set-up reports, If applicable. <br />■ Yes <br />❑ No* <br />Is all monitoring equipment operational per manufacturer's specifications? <br />* In Section E below, describe how and when these deficiencies were or will be corrected. <br />E. COMMENTS <br />Liquid was removed from 87, 91 STP and fill sumps and placed in hazmat drum on site. <br />Page 2 of 3 <br />