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01(02/1995 03:27 2097 i22 <br /> CALAVERAS Er'r✓ HL t PAGE 03 <br /> sa Ater Ag System Certlft;;ItSoiu <br /> • �� j�� .�� ` ..iii.c of 1 ril3llg,.�CtF'>Ilt7g: :) <br /> - Facility Name: / <br /> IF. In-Tank Gauging Equipment: C1 Check this box if tarsi gouging is used only for inventory control. <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. <br /> Software version Installed: <br /> Com lett the follewtn cheek3ist: <br /> Yes ❑ No* Has all bVut wu'ing b_cu uupected for proper envy and termination,including testing for ground faults? <br /> ❑ Yes iM No' Were all tank gauging probes visually inspected for daan-Age and residue buildup'' <br /> © Yes W No' Was accuracy of sysmizi productlwastc level readings tested? <br /> Q Yes Et No' Was accuracy of systcm wain level readings resod? <br /> p yes 0 No' I Were all alarms activated and did they function properly? <br /> 51 Yes 0 No, Were 111 11=13 on the equipment manufacturer's maintenance intene checklcst completed? <br /> LIS <br /> IA the Section EL l dow,describe how and when these deficiencies were or wltl he corrected_ <br /> G. Line Leak Detectors(LLD): 0 Check this box if LLDs are not installed. <br /> Corn tete the folionl theekl6t: <br /> ® Ya Cl No* Was a leak simulated to verify perfo nAnce?(Check all Char apply) <br /> Simulated leak rate: J9 3 g.p.h.; 0 0.1 g.p_h.; O 0.2 g.p_h. <br /> Yes i7 No' Were all LLD3 confirmed operational and accurate within,regulatory requitcments? <br /> I Ycs 0 No' Was the testing apparatus propmly calibrated? <br /> p Ycs O N ' For mechanical LLDs,does the LLD resaict product flow if it de <br /> [ecu a leak? <br /> No.* <br /> g NIA <br /> !� Yes D No` For electronic LLDs.,does the turbine automatically shut off if tht LLD dc:ecu a fear? <br /> D NIA <br /> Yes 0 No' For elcctrnnic LLDs,does she ridbine automatically shut off if any portion of the monitoring system is disabled <br /> ❑ NIA or disconnected? <br /> Fn Ycs 0 No' For electronic LLDc, docs the turbine automatically shut off if any portion of the rrtoaitoring sys:ua <br /> ❑ N/A aalfuaeaous or fails It test? <br /> .gp yes ❑ No' For ekctronic LLDs,have all accessible wining cmnections been visually inspMied? <br /> D NIA <br /> 0 1'es D No' If necessary to proper equipment operation,are furl filters in good condition' <br /> ® NIA <br /> 6p� C] No` Were nil items oo the equipment manufacturer's mat-ltenancc checklist completed? <br /> . <br /> In the Seaton H,below,describe how and when these deficiencies were or will be corrected. <br /> H. Cornments• <br /> CALM-at <br /> Page 3 ocr'r� <br /> E 'd 2bE9I9t,602 ouI SJ040eJ4u00 AI a4113 eLS :80 20 01 400 <br />