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02-09-'06 10:41 FROM-Wig 7076932922 T-221 P004/005 F-224 <br /> J, 40 <br /> Cal,Code Rega.Tiffs 23,Division 3,Chapter 78,Underground Tank Regulations <br /> F. In-Tank Gauging/SIR Equipment: ❑ Check this box if tank gauging is used only for inventory control. <br /> ❑ Check this box it no tank gauging or SIR equipment is instalied. <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. <br /> C_ i ohecidlst: . .-. -- <br /> Yes ❑ No" Has all fnputwiring bean inspected for proper entry and tOrramation,7nduding testing for ground faults? <br /> Yes 0 Nu' Wereell tankgaugig probes visually inspected for damage and residue buildup? <br /> Yas ❑ Nor Wasaccuraaydtsystemprod..lev.readkgstea[ <br /> Yes ❑ NO' Wes acdmmcyof system water temrel radings tasted? <br /> Yes ❑ No` Were a%Probes reinstalled pmperW? <br /> Yes ❑ No• Were ag items on the agNpnrad manufadurels malntenenoc checklist completed? <br /> In the Section H,below,describe how and when these desciendes were or will be corrected. <br /> G. Line Leak Detectors(LLD): ❑ Check this box if LLDs are not installed. <br /> Com tato thafonowl chsckIIst:. ---- <br /> Yes ❑ No* Forequlpment start-up or annual uipment csrOficadon,was a teak simulated to vehify LLD Performance?(Check all <br /> ❑ WA dwtepply) Simulated teak rate:73 g.P.h.; ❑0.1 g.p.h: ❑0.2 g.p.h. <br /> ❑ Yes ❑ No' Were all LLDs confirmed operational and accurate within rsgoratory requirements? <br /> ❑ Yes ❑ No' Was the testing aPparaWs PmPany oapbrated? <br /> ❑ Yos ❑ No" For mechanical LLDs,lass the LLD reairid Pmduc flow if it defects a teeth <br /> ❑ WA <br /> Yes ❑ No Forel sobonic ILDs,does the turbine autamelloaty,shut o0 Wthe LID detects a leak? <br /> ❑ WA <br /> Yes ❑ No` For electronic LLDs,doss the turbine automallcaity strut off d any potion cf the monirorfig sys�em'u^disabled or <br /> ❑ WA r%sownected? <br /> Yes O No" fBcborhic LLDs.dose lheturhine aufomaticaily snot og if any portion of the monitoring system marfun.lons or❑ WA test? <br /> Yes ❑ No* ec6ontc LLDs,have a8 accessible wiring contraction been visually brepsdad?❑ WA <br /> Yes ❑ No` allilemson the equipment manufactumrs maintenance checklist canpfated? - <br /> In the Seeuon H.hot".describe how and when these deflcienies were or wnt be corrected. <br /> H- Comments: <br /> Monitoring SyMcm Car6Yloftu 1 Page 3 of 08101 <br /> . 11U- <br />