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Facility Name: Village West Ana (Page 3) In -Tank Gauging: ❑ Check this box if tank gauging is used only for inventory control and disregard following section. ® Check this box if no tank gauging or SIR equipment is installed and disregard the following section. Complete the following checklist: ❑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 ❑ 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? El Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed and disregard the following section ❑Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD ❑ N/A performance? (Check a// that app/y) Simulated leak rate: ® 3 gph.; ❑ 0.1 gph ; ❑ 0.2 gph. ®Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? ❑Yes ❑ Duh Was the testing apparatus properly calibrated? ®Yes ❑ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ❑ N/A F-1 Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ® N/A ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system ® N/A is disabled or disconnected? ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system ® N/A malfunctions or fails a test? ❑ Yes ❑ No* For electronic LLDs, have all accessible wiring connections been visually inspected? ® N/A ❑Yes I ❑ No* 1 Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: