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2186: 3212 N CALIFORNIA, r' `;KTON, CA 95204 Dater stir ervic' 10/12r2005 - - ---ice -$— F. In -Tank Gauging/ SIR Equipment: Check this box if tank gauging is used only for inventory control. Check this box if no tank gauging or SIR equipment is Inst. alled. This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. Complete the fallawing checklist: * Ix the Section H, below, describe how axd when these deficiencies were or will be correcte d. G. Line Leak Detectors (LLD): M' Check this box ifLLDs are not installed. Complete the followine checklist: hy Yes No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? No* Were all tank gauging probes visually inspected for damage and residue buildup? Was accuracy of system product level readings tested? UYes 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? * Ix the Section H, below, describe how axd when these deficiencies were or will be correcte d. G. Line Leak Detectors (LLD): M' Check this box ifLLDs are not installed. Complete the followine checklist: hy Yes No* For equipment start -tip of annual equipment certification, was a leak simulated to verify LLD performance? NIA (Check all that apply) Simulated leak rate: .3 g.p h.l; 0.1 g.p.h.2; S 0.2 g.p.h.2 Notes: 1. Required for equipment startup celti cation 9t1d annual certification. 2. Unless mandated by local agency, certification required only for electronic LLD start-up. Yes No* Were all LLDs confirmed operational and accurate within regulatory requirements? Yes No* Was the testing apparatus properly calibrated? Yes M11N o* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? NIA Yes No* For electronic L.LDs, does the turbine automatically shut off if the LLD detects a leak? NIA Yes No* For electronic LLD9, does the turbine automatically shut off if any portion of the monitoring system is disabled NIA or disconnected? Yes No* For electronic LLD s, does the turbine automatically shut off if any portion of the monitoring system malfunctions NIA or fails a test? Yes No* For electronic LLDs, have all accessible wiring connections beer. visually inspected? NIA Yes No* Were allitems onthe equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe kow and whex these deficiencies were or wiu de corrected. H. Comments: Page 3 of 3 03.01