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MAY-28-2010 19:54 Service Station Systems 408 938 8880 P.07 r ' • Monitoring System Certification-Pas of 3 Site Address: 2448 W. Kettleman Ln. Date of Testing/Servicing: 4130110 F. In -Tank Gauging/SIR Equipment: ❑ Check this box if tank gauging is used only for inventory control. 0 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 dot, tion monitoring. Complete the following checklist: ❑ Yes ❑ No* Has all input wiring been inspected for proper entry and termination, includin testing for ground faults? 0 Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue hu dup.) ❑ 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 j ❑ No* Were all items on the equipment manufacturer's maintenance c cklist completed? * In Section H below, describe how and when these deficiencies were/tb' box corrected. G. Line Leak Detectors (LLD): ❑ Checif LLD's are not installed. Complete the follo ing checklist: ❑ Yes ❑ No* For equipment start-up or annual equipment certif ation was a leak simulated to verify LLD performance? ❑ N/A (Check all shat apply) Simulated leak reate;❑ a.p.h.(1); 110.1 g.p.h. (2.); ❑ 0.2 g.p.h. (2). Notes: 1. Required for equipment start-up rtification and annual certification. 2. Unless mandated by local a en , certification required only for electronic LLD start-up. ❑ Yes ❑ No* Were all LLD's confirmed operational andAccurate within regulatory requirements? ❑ Yes ❑ No* Was the testing apparatus properly calib ted? 0 Yes p No* For mechanical LLD's, does the LLD r strict product flow if it detects a leak`? ❑ N/A 0 Yes ❑ No* For electronic I,L.D's, does the turb' e automatically shut off if the LLD detects a leak? [I N/A ❑ Yes ❑ No* For electronic LLD's, does the rbinc automatically shut off if any portion of the monitoring system is disabled 0 N/A or disconnected? ❑ Yes M No* For electronic LLD's, does e turbine automatically shut off if any portion of the monitoring.system ❑ N/A malfunctions or fails a to . ❑ Yes ❑ No* For electronic LLD's,ve all accessible wiring connections been visually inspected? 0 N/A ❑ 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: TOTAL P.07