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pV-28-2006 09:37 ice Station Systems <br /> 408 938 8888 P.04 <br /> O Cheek thfa b ...•.,......� „'•u,.�„w.y wuuur. <br /> no tank gaugiug or SII equipment is installed. <br /> This section must be cowplettd if ir.. <br /> �aaul�ng e9�Pm s used to etfo <br /> Com let e the foUowia cheekllrt: rm lesik detection monitoring. <br /> 0 Yea ❑ Nor Has all is ut whip been. <br /> G « S tnapccted f raper entry and termfnatiou,fucluding testing for ground faults? <br /> ❑ Yes N0* Wire all tank gauging probes bi ly ins ected for dame a end <br /> ❑ NO Wes accuracy of xystem p ct level readings tasted? g residue Buildup? <br /> Q Yes ❑ Na* Was axuracy of syste atdr Leval readlnin tested? <br /> ❑ Yes O Na' Were all probes rei ed properly? <br /> D as D No* Were all items the equipruent Manufhcturer's maintenance checklisr <br /> *In the Section H,below,des be how and when these deflcleneies were or wdl be corrected. <br /> nEiii <br /> G. Line Legg Detectors(LLD): 7 <br /> ❑ Check this boz ifLLDs are not installed. <br /> Corp Leto the followla checklist: <br /> Yes Cl No” For equilxnalis staraup ar annual equipment cer"Cuion, was a Jeek simulated to verity LLn perfarrnance? <br /> Q NIA (Chsok all that apply) Or <br /> leak rate: <br /> ,cf'!�3 g.p.h.; ❑0.1 g.p,h; ©U.2 g.p.h. <br /> Yes D Na' Were all LLD-corated operational pad eCCt7rAtq within rsgulnt <br /> Yes aryrequirements? <br /> Q No* Was the testing app��properly calibrated? <br /> Yes ❑ No* For nlechaa{cal <br /> © Nit. LI-Vs,does the LLL)restrict praduet flow if it detects a leak? <br /> 0 Yes Q No' For elootrouic LLDs,docs the turbine auturuatically shut olrif the LLD detects a leak? <br /> MIA <br /> 0 Yes p No* For electronic LI.1]s,0009 the turbine automatically shut oii ff an <br /> N/A or disconnected? y portion of the nwuftoring system fs disabled <br /> (7 Yes la No" For eleetreaic LLDs, 'does the turbine autoulati <br /> 0NlA malfunCtioas or fails a test? �5' shut off if any portion of the monitoring system <br /> ❑ Yes 0 No* <br /> -0 NIA For electronie I LD$,have all accessible wiring connections been visually inspected? <br /> Yes Q Not' Were all items on the equipmentmatuifacturer's auiateneaoe oheeklfat camptetrd? <br /> *7n tiro Section Ii,below,dost dhe now and when these dellclencles were or will be Corrected, <br /> H. Corrlraents: t,..14 S' A ML-o <br /> �-v� �+ 5 IS t,.ltari. <br /> Page 3 of 3 <br /> 09lD3 <br />