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Site Address X6100:25775 S PATTERSC ASS,TRACY,CA 95376 i D f T a stinWServicing: F.' In-Tank Gauging I SIR Equipment: Check this box if tank gauging is used only for inventory control. CheckCheck this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the follow' checklist: Ye" 21 Has all input wiring been inspected for proper entry and termination,including testing for ground faults? Yes No* Were all tank gauging probes visually inspected for damage and residue buildup? Yes No* Was accuracy of system product level readings tested? Yes No* Was accuracy of system water level readings tested? Yes No* Were all probes reinstalled properly? Yes No* Were all items on the equipment manufacturer's maintenance checklist completed? *In the Section H,below,describe kow and when these deficiencies were or will be corrected. C. Line Leak Detectors (LLD): Lj Check this box if LLDs are not installed. Complate tke following ckeeklist: Yes No* For equipment startup or annual equipment c cats was a leak simulated to verify LLD performance? NIA (Check all that apply) Simulated leak rate: g.ph.1; 1 0.1 g.ph.2; M 02 g.p h.2 Notes: 1. Required for equipment sWt.up certificationMW annual certification. 2. Unless mandated by local agency,certification required only for electronic LLD start-up. Ps No* Were all LLDs confirmed operational and accurate within regulatory requirements? Yes No* Was the testing apparatus properly calibrated? Yes N FormechanicalLLDs,does the LLDrestrict product flow ifitdetects aleak? IA as No* For electronic LLDs,does the turbine'automatically shut off if the LLD detects a leak? NIA O"Yes No* For electronic LLD s, does the turbine automatically shut off if any portion of the monitoring system is disabled NIA or disconnected? Yes No* For electronic LLDs, does the turbine automatically shut off if anyportion of the monitoring system malfunctions NIA or fails a test? es No* For electronic LLDs,have all accessil l,e wiring connections been visually inspected? ZI NIA alyes 11, No* Were all items on the equipment mat:ufacturer's maintenance checklist completed? *In the Section H,below,describe kow and wken tkese,deficiencies were or will be corrected. M Comments: I 7 � I I 1 1 I I E L - � I t • t . I i I Page 3 of 3 03r81