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r <br /> MONITORING SYSTEM CER171FICATION <br /> For Un By All Jurisfaflom iffthin Ow Raft of Cafornia <br /> Authority Cited:Chapter 6.7, th C .1 6,Division 3, 7111e 23, CalOrnia Code of Rexd&Wons <br /> This form must be used to document tooting and servicing ofmonitoring equipment.A aj9KAg jW&99M a awt ba urapared <br /> &jAgL=njt&dpg 23Efft4m control wd by the tecbnicion who performs the work A copy of this form must be provided to the tank <br /> system ownerfoperator. The ownedoperatm must submit a copy of this form to the local agency regulating UST systems witbin 30 <br /> days of test date. <br /> A. General Information <br /> FacilrNameT *BP WEST COAST PRODUPTS. LLC i$ 6347 <br /> Site Address: (2430 JOE POMBU PKWY City t TRACY I lap: 195376 <br /> Fnc C ct Pere oac t4.a Contact No.: S z 5'"-SwT <br /> Make/Model ofMoni System: - Dote ofTestin arvico: -i3`�S <br /> B. Inventory of Equipment Tested/Catified <br /> Check the a=Aate bow to hulicatereflicment ied1 <br /> Tank W: 87 <br /> Tank4aupn_g�Probe: Model 54-7310 -(019 T Probe: Model: 0-to <br /> ularS ace orVaUUSenoor. I Model: W4q4 "510'-i4OS LEAnnulerS ace or Vault Sensor Model O- p <br /> Sum Tench Sensors : Model v t S ranch S or : Model: <br /> s�S Sonsor s : Model Q> S Sensors : Model •� <br /> ochorsicalline Look Detector, Mo NWechanical Line Leak Detector. Model: <br /> ectronicLine Leak Detector Model: ZZr- Y ectronicLine Leak Detector Model <br /> Ma pool t as i aril Model '796o !-o®f <br /> eSpeci&em*.t o and model;-Section:E on P axe.2 tl►er S oc' a e and model in Section E M..P%*2 <br /> Tank ID: L Tank ID: <br /> Tank 0augingProbe: Model 1841,510`(® TankGauging Probe: Model <br /> rrn�slar S ace or V ault Sensor Model `y p u1or space or Vault Sensor Model <br /> §2gegranchSensors : i Model '�4 -ZAM g§wRqr@=hSonsox s : I Model- <br /> -gum <br /> odel Sanson(0): Madel ; ills S or s : Model <br /> ech al <br /> Line Leak Detector. Madol: k�l4- bO echanical line Look Detector. Model: <br /> ctr c Dane Leak Detector Model: 1 RMockunic.Lane Leak Detector Modal: <br /> Ova Model i"'T4 !-oat ffrW*OvedMftS&1mlSensor I Model- <br /> S ac' o ' .=0 and model in Section E on P e t 5 Spectfa .!Me and model in Section Eon Page 2 <br /> DisponserlD: a _Z sneer II, 3� <br /> o entSensors: Modal enserG ntSens s : Model: 2D <br /> Itep�4"e9MV11019�r4ce <br /> censerFlon s andGh ° s enserC entFloa s and Ch ' s <br /> fr ID: 'S-Ca Dis erzser ID: '?~ <br /> nserContainmentSensors: Model: ?O� s ens erContainmentSensor(s): Model: ZU'8 <br /> eervaly nserCont ' entFlo sand s_ er ContainmentFloa s and_ ' s <br /> DispenserID: i 9-to D` sneer M: /"Z <br /> ensorC entSensors: I Modal 2 enserC ntSonso s: Model: U <br /> oarvelve s . ear Veiy .s . <br /> moor Containment Flo!%s)and ' s er C. . ent Flo s and Ch '. s <br /> hf the facWty contains more tanks or dispensers,copy this form: Include information for every tank and dispenser at this facility. <br /> C. Certification-I ce t the ejukrAent ideaffiet iA tleis docwoontwas hwpectedWrvicedin aaordwwe with the man ' <br /> Attached to this CerdfimfieR in h&mmdox an'cher j necesseq t0 verffy that this infiarmation U <br /> connect a t t of Y&OaUn For capable of generaft sash report,l huesbo <br /> a a c of the r4(cheA aUSystem set-'up Whotory ropext <br /> FTectr ca Namce: <br /> Cezfafication No.: License No.: <br /> To ^Ca Name: L TAIT NMENTALSYST i Phone No.: 1, Ql!j 1&8222 <br /> Pap l.of 3 03101 <br />