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10/04/2004 02:50 2093653 TANKNOLOGY • PAGE 12 <br /> Monitoring System Certification <br /> she address: 2500 W. LODI AVE. Date of Tesang/Service: 09/29/2004 <br /> (M LOWER SACRAMENTO RD. <br /> F, In-Tank Gauging l SIR Equipment Q Check this box if tank gauging is used only for Inventory Control. <br /> ❑ Check this box h no tank gauging or SIR equipment is installed. <br /> This section must be completed If in-tank gauging equipment Is used to perform leak detection monitoring. <br /> Complete the following chackilat; <br /> ❑Yea ❑No' Has all Input wiring been inspected far proper entry and termination,including testing for ground fauhe? <br /> ❑Yea r7No' Were all tank gauging probes visually inspected for damage and residue buildup? <br /> Yes ©No' Was accuracy of system product level readings tested? <br /> ©Yea ❑No. Was accuracy of system water level readings tested? <br /> Yes ❑Ne' Were ah probes reinstalled property? <br /> ❑Yes ❑No' Were all hems on the equipment manufacturers'maintenance checklist Completed? <br /> 'In the 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 file following checklist: <br /> For Q Yes El No' C]NIA (Check <br /> 0 ent start-up or annual that apply)Simulated leek rale:equipment Certification, <br /> 3 g ptlh[—]0.1 g.p.h aQ02ed to g.p, hverify LLD performance? <br /> aye. ❑No" Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> MR Yes ❑No^ Was the testing apparatus property calibrated? <br /> my" ❑No' 0 WA For mechanical LLDs,does the LLD restrict product flow 0 0 detects a leak? <br /> ❑Yes ❑No" O NIA For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> ❑Yes [:]No" Q NIA For electronic LI-Ds,does the turbine automatically shut off N any portion of the monitoring system is disabled or disconnected? <br /> ❑Yes ❑No' Q NIA For electronic LLDs,does the turbine automatically shut aR R any portion of the monitoring system malfunctions or falls a test? <br /> r❑y Yes ❑ND' O NIA For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> u yes ❑No" Were all items on the equipment manufacturers'maintenance checklist completed? <br /> "In the Section H,below,describe how and When these deficiencies were or will be corrected. <br /> H. Comments: <br /> page 3 of 3 <br />