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"BREFacility Name: Costco # 658 Tracy (Page 3) CEIVED In-Tank Gauging: SEP 3 0 2016 ❑Check this box if tank gauging is used only for inventory control. Complete the following checklist: ENVIRONMENTAL HEALTH ®Yesjin g p MENT ❑ No* Has alwiring been inspected for proper entry and termination, including testing for ground fa u I ts ®Yes ❑ No* Were ing probes visually inspected for damage and residue buildup? ®Yes ❑ No* Was astem product level readings tested? ®Yes ❑ No* Was astem water level readings tested? ®Yes ❑ No* Were nstalled properly? Yes ❑ No* Were ahe equipment manufacturer's maintenance checklist completed? * in Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed and disregard the following section. FZYes equipment P ❑ No* Fore ui ment start-u or annual equipment certification, was a leak simulated to verify LLD ❑ N/A performance? (Check all that apply) Simulated leak rate: ® 3 gph.; ❑ 0.1 gph ; ❑ 0.2 gph. ❑ No* Were allLLDs confirmed operational and accurate within regulatory requirements? ❑ No Was the testing apparatus properly calibrated? ❑ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ❑ N/A ®Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ❑ N/A ®Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system— El N/A is disabled or disconnected? ®Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system ❑ N/A malfunctions or fails a test? ®Yes ❑ No* For electronic LLDs, have all accessible wiring connections been visually inspected? ❑ N/A ®Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: