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JUL-02-2010 16:38 Service Station Systerns 408 938 8888 P.06 Monitoring System Certification - Pat, of 3 Site Address: 1987 West 11Th. Street Date of Testing/Servicing: 6/2/10 F. In - Tank Gauging / SIR Equipment: 3 Check this box if tank gauging is used only for inventory control. Q Check 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. C omnlete the fnllnwina checklikt- ❑ Yes ❑ No* 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 Cl No* Was accuracy of system product level readings tested? ❑ Yes ❑ No* Was accuracy of system water level readings tested? Q Yes ❑ No* Were all probes reinstalled properly? ❑ Yes ❑ No* Were all items on the 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 LLD's are not installed. Comnlete the followine checklist: ix Yes ❑ No' For equipment start-up or annual equipment certification was a leak simulated to verify LLD performance'? El N/A (Check all that apply) Simulated leak reate: Ct 3 g.p.h. (I.); ❑ 0.1 g.p.h. (2.); ❑ 0.2 g.p.h. (2.). Notes,. 1. Required for equipment start-up certification and annual certification. 2, unless mandated by local agency, certification required only for electronic LLD start-up. tS Yes ❑ No* Were all LLD's confirmed operational and accurate within regulatory requirements? 11 Yes ❑ No* Was the testing apparatus properly calibrated? ❑ Yes ❑ No* For mechanical LLD's, does the LLD restrict product flow if it detects a leak? iX N/A CK Yes ❑ No* For electronic LLD's, does the turbine automatically shut off if the LLD detects a leak? ❑ N/A (I Yes ❑ No* For electronic LLD'%, does the turbine automatically shut off if any portion of the monitoring system is disabled I Ll N/A or disconnected? 11 Yes ❑ No* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system ❑ N/A malfunctions or fails a test? 2 Yes ❑ No* For electronic LLD's, have all accessible wiring connections been visually inspected? ❑ N/A ix Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? * in Section H below, describe how And when these deficiencies were or will be corrected. H. Comments: