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' 10- 2-06;12:00PM;Secremen*- EMC <br />;916 92523:0 # 4/ 11 <br />Sacramento Equipment Maintenance Company, Inc <br />Work Order # 122462 <br />Site Address: <br />7/11 #19976 <br />Date of Testing/Servicing: <br />08-16-06 <br />Fo. equipment start-up or nual equipment certification, was a leak simulated to verify LLD performance? <br />(Check all that apply) <br />1399 North Main Street <br />Were all tank gauging probes visually inspected for damage and residue buil p? <br />0.1 g.p.h? <br />Manteca, Ca. 95336L <br />1 <br />Was accuracy of system water level readings tested? <br />i 209-239-3232 <br />'?Vere all probes reinstalled properly? _ <br />F. In -Tank Gauging i SIR Equipment Check this box if tank gauging is used only for inven ,r control. <br />Check this box if no tank gauging or SIR equi ent is installed. <br />This section rr u 1, bc; completed if ir'==-tank gzuging equipment is used to perform leak detection :nonitoryt' .g <br />Yes <br />No <br />Coriplete the ;`oilowing checklist: <br />Has all input wiring been inspected for proper entry and termination, including te-`' g for ground faults? <br />Fo. equipment start-up or nual equipment certification, was a leak simulated to verify LLD performance? <br />(Check all that apply) <br />Simulated Leak rate: <br />Were all tank gauging probes visually inspected for damage and residue buil p? <br />0.1 g.p.h? <br />Was accuracy of system product level readings tested? <br />Was accuracy of system water level readings tested? <br />1 Were al' LT—Ds c f rrned operaticnal and accurate within regulatory requirements? <br />'?Vere all probes reinstalled properly? _ <br />on the eq roment TMzanufacturers's main te ce checklist completed,? <br />(P b:, � shaded boxes need :ao describe how ani when:'these defic rtes. were orwzll be corrected m Sectton. H below) <br />G. Line Leak Detectors (LLD): <br />Y I Check this box if LLDs are not installed: I <br />a <br />Yes No <br />N/A^omplete <br />the folio Hing check '�t: ^` _- <br />Fo. equipment start-up or nual equipment certification, was a leak simulated to verify LLD performance? <br />(Check all that apply) <br />Simulated Leak rate: <br />3 g.p.h.1; <br />0.1 g.p.h? <br />C.2 g.p.h? <br />1 Were al' LT—Ds c f rrned operaticnal and accurate within regulatory requirements? <br />! Was the test apparatus properly calibrated? <br />1 <br />Fo mech ical LLDs, does the LLD restrict product flow if it detects a leak? <br />I <br />For el ,tropic LLDs, does the turbine automatically shut off if the LLD detects e leak? <br />F,,/electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or <br />d' _onnected? <br />For. electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a <br />test? <br />i'rr electronic LLDs, have all accessible wiring connections been visually inspected? <br />Were all items on the equipmenmanufacturer's maintenance checklist completed? <br />r_ <br />i(Above shaded boxes reed ;o describe how and when these. deficiencies were or. will be.correcte3 in Section H below) <br />A. Comments: <br />03/01 ­_ _____ _ ��� cot-,nty/0000£/statc5-monitoringcert.wpd ��� Page 3 of 5 F <br />