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MONITORING SYSTEM CERTI`CATION <br />CERTIFICATION /TEST DATE: Mav 07, 2014 <br />Al. FACILITY A2. OWNER <br />Name Quik Stop Market #120 Name Quik Stop Markets, Inc. <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 />IF. IN -TANK GAUGING / SIR EQUIPMENT: <br />■ Check this box if tank gauging is used only for inventory control. <br />❑ Check this box if no tank gauging or SIR equipment is installed. <br />This section must be completed if in -tank gaugung equipment is used to perform leak detection monitoring. <br />Complete the following checklist: <br />❑ <br />Yes <br />❑ <br />No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />❑ <br />Yes <br />❑ <br />No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />❑ <br />Yes <br />❑ <br />No " <br />Was accuracy of system product level readings tested? <br />❑ <br />Yes <br />❑ <br />No* <br />Was accuracy of system water level readings tested? <br />❑ <br />Yes <br />❑ <br />No* <br />Were all probes reinstalled properly? <br />❑ <br />Yes <br />❑ <br />No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />" In Section H below, describe how and when these deficiencies were or will be corrected. <br />Page 3 of 3 <br />