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3 ` <br /> BEAC€SN <br /> RELEASE (Leak) EVALUATION PROCESS <br /> CHECK LIST <br /> Station# Tank# Tank Size Product Date <br /> Check off each step as it is completed. If completion of any of the steps reveals the reason for <br /> exceeding the allowable variation it is not necessary to complete the remainder of the steps. <br /> TO BE PERFORMED BY STATION MANAGER <br /> Date/time: <br /> Step 1 Records reviewed/regauge tank <br /> Performed by: <br /> Date/ me: <br /> Step 2 New reconciliation performed <br /> Performed by: <br /> Datettime: <br /> Step 3 Station physically inspected for evidence of leaks. <br /> Performed by: <br /> ❑ Check all skirts and dispensers for leaks. <br /> ❑ Check all unions,fitting, 4 filter. Also check for strong gasoline <br /> odor 1-2 minutes after opening skirts. <br /> ❑ Check all hoses and nozzles for leaks. <br /> ❑ Check all totalizers, meters, impact valves for tampering. <br /> Step 4 Notify Zone Manager if there is any evidence of leak or if the Date/time: <br /> above steps have not revealed the reason for exceeding the Performed by: <br /> allowable variation. <br /> TO BE PERFORMED BY ZONE MANAGER <br /> Date/time: <br /> Step 5 Records reviewed and audit performed. <br /> Performed by: <br /> Date/time: <br /> Step 6 Calibration on dispenser meters checked. Performed by: <br /> TO BE PERFORMED BY HANFORD OFFICE <br /> Date/time: <br /> Step 7 Hydrostatic Pressure Test performed. Performed by: <br /> Date/time: <br /> Step 8 Precision Tank Test performed. Performed by: <br /> Describe briefly the reason the allowable variation was exceeded. <br /> I hereby certify this to be a true and accurate report. <br /> Signature Date <br /> 3 134 <br />