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MONIT ING SYSTEM CERTIOkATION <br />CERTIFICATION /TEST DATE: January 16, 2013 <br />A1. FACILITY <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 />A2. OWNER <br />❑ Yes ❑ No * Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />Name <br />Tower Mart # 104 <br />Were all tank gauging probes visually Inspected for damage and residue buildup? <br />Name <br />Tower Energy Group, Inc.. <br />Address <br />192 Lathrop Road, Lathrop, CA 95330 <br />❑ Yes ❑ No* <br />Address <br />1983 West 190th Street, Torrance, CA 90504 <br />Phone # <br />209-858-4998 <br />■ <br />Phone # <br />916-285-7402 ext 100 <br />Contact <br />Desiz Burns <br />In Section H below, describe how and when these deficiencies were or will be corrected. <br />Contact <br />Mark Vasey <br />F. IN -TANK GAUGING 1 SIR EQUIPMENT: ■ 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 />❑ Yes ❑ No * Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />■ <br />❑ Yes ❑ No* <br />Were all tank gauging probes visually Inspected for damage and residue buildup? <br />No* <br />❑ Yes ❑ No* <br />Was accuracy of system product level readings tested? <br />Yes <br />❑ Yes ❑ No* <br />Was accuracy of system water level readings tested? <br />For mechanical LLDs, does the LLD restrict product flow If it detects a teak? <br />❑ Yes ❑ No* <br />Were all probes reinstalled properly? <br />■ <br />❑ Yes ❑ No* <br />Were all Items on the equipment manufacturer's maintenance checklist completed? <br />■ <br />Yes <br />In Section H below, describe how and when these deficiencies were or will be corrected. <br />G. LINE LEAK DETECTORS (LLD): ❑ Check this box if LLDs are not installed. <br />Complete the following checklist: <br />■ Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br />❑ NIA (check all that app1y1 Simulated leak rate: ■ 3 g.p.h.; ❑ 0.1 g.p.h.; ❑ 0.2 g.p.h. <br />■ <br />Yes <br />❑ <br />No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />■ <br />Yes <br />❑ <br />No* <br />Was the testing apparatus properly calibrated? <br />❑ <br />Yes <br />❑ <br />No* <br />For mechanical LLDs, does the LLD restrict product flow If it detects a teak? <br />or fails a test? <br />■ Yes <br />■ <br />NIA <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />■ <br />Yes <br />❑ <br />No* <br />For electronic LLDs, does the turbine automatically shut off If the LLD detects a leak? <br />❑ <br />NIA <br />■ Yes <br />❑ <br />No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />❑ <br />NIA <br />or disconnected? <br />■ Yes <br />❑ <br />No* <br />For electronic LLDs, does the turbine automatically shut off If any portion of the monitoring system malfunctions <br />❑ <br />NIA <br />or fails a test? <br />■ Yes <br />❑ <br />No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />❑ NIA <br />N Yes ❑ No* 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 />H. COMMENTS <br />87-1 and 87-2 are manifolded with a single PLLD. <br />nm <br />Page 3 of 3 <br />