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r MONIT(.ING SYSTEM CERTIF*ATION MAKE / MODEL OF MONITORING SYSTEM: Gilbarco EMC CERTIFICATION /TEST DATE: August 14, 2006 A1. FACILITY A2. OWNER Name Miramar Enterprises Name Angle Enterprises Address 1605 S. EI Dorado Street, Stockton, CA 95206 Address 35584 Conavan Lane, Fremont, CA 94536 Phone # 209-939-1906 Phone # 510-552-4822 Contact Balaji Angle Contact Balaji Angle A3. C U P A A4. TESTING CONTRACTOR Name San Joaquin County Environmental Health Name Walton Engineering, Inc. Address 304 E Weber Avenue, 3rd Floor, Stockton, CA 95202 Address P.O. Box 1025, W. Sacramento, CA 95691 Notified August 1, 2006 Lic # 617238 A, B, Haz Inspector Raymond Von Flue Contact Richard Walton Phone # 209-468-9847 Phone # 916-825-3203 B. INVENTORY OF EQUIPMENT TESTED/CERTIFIED (Check the appropriate boxes to indicate equipment inspected/serviced) B1: TANKS - Tank #1 (Product): Gasoline - 87 ---- - 1 Tank #2 (Product): Gasoline - 91 ■ In -Tank Gauging Probe Model: 0847390-109 ■ In -Tank Gauging Probe Model: 0847390-109 ■ Annular Space or Vault Sensor Model: 0794390-420 ❑ Annular Space or Vault Sensor Model: 0794390-420 ■ Piping Sump I Trench Sensor(s) Model: 0794380-208 ■ Piping Sump I Trench Sensor(s) Model: 0794380-208 ❑ Fill Sump Sensor(s) Model: ❑ Fill Sump Sensor(s) Model: ■ Mechanical Line Leak Detector Model: Red Jacket FX ■ Mechanical Line Leak Detector Model: Vaporless LD -2000 ❑ Electronic Line Leak Detector Model: ❑ Electronic Line Leak Detector Model: ❑ Tank Overfill I High -Level Sensor Model: ❑ Tank Overfill / High -Level Sensor Model: ❑ Other (specify equipment in Section E) Model: ❑ Other (specify equipment in Section E) Model: Tank #3 (Product): Tank #4 (Product): ❑ In -Tank Gauging Probe Model: ❑ In -Tank Gauging Probe Model: ❑ Annular Space or Vault Sensor Model: ❑ Annular Space or Vault Sensor Model: ❑ Piping Sump / Trench Sensor(s) Model: ❑ Piping Sump I Trench Sensor(s) Model: ❑ Fill Sump Sensor(s) Model: ❑ Fill Sump Sensor(s) Model: ❑ Mechanical Line Leak Detector Model: ❑ Mechanical Line Leak Detector Model: ❑ Electronic Line Leak Detector Model - ❑ Tank Overfill I High -Level Sensor Model: ❑ Electronic Line Leak Detector Model: ❑ Tank Overfill / High -Level Sensor Model: ❑ Other (specify equipment in Section E) Model. ❑ Other (specify equipment in Section E) Model: B2: DISPENSERS/UDC's Dispenser # 1-2 Dispenser # : 3-4 ■ Dispenser Containment Sensor(s) Model: 0847990-001 ■ Dispenser Containment Sensor(s) Model: 0847990-001 ■ Shear Valves ■ Shear Valves i ❑ Dispenser Containment Float(s) and Chain(s) ❑ Dispenser Containment Float(s) and Chain(s) Dispenser # : 5-6 F Dispenser # - ■ Dispenser Containment Sensor(s) Model: 0847990-001 ❑ Dispenser Containment Sensor(s) Model: ■ Shear Valves ❑ Shear Valves ❑ Dispenser Containment Float(s) and Chain(s) ❑ Dispenser Containment Float(s) and Chain(s) Dispenser # : ❑ Dispenser Containment Sensor(s) Model: Dispenser # ❑ Dispenser Containment Sensor(s) Model: ❑ Shear Valves ❑ Shear Valves ❑ Dispenser Containment Float(s) and Chain(s) J ❑ Dispenser Containment Float(s) and Chain(s) C. CERTIFICATION I certify that the equipment identified in this document was inspectedlserviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this information is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the report; (check all that apply): ■ System set-up ■ Alarm History Report WALTON - Signature: ENGINEERING, INC. Technician / Cert M Bruce N. Stewart / A31131 5249892 -UT Date: August 14, 2006 v cvuo rvauun cnymeenny, u�c.