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SHELL OIL COMPANY-CERTIFICATION PAGE 3 OF 3 <br /> STATION ADDRESS 270o o d FACILITY WIC# Zov 2— <br /> ANNUAL CHECKLIST FOR SERVICE STATIONS <br /> X1 . Are al 1 • of the impact val ves secure and i n good worki rig order? `l.-S <br /> y2. Are all of the fill adaptors secure? Ye,S <br /> 4. Are .all of the fill caps in good working order and properly seal? V.-ei <br /> 4. Are the line 'pressure monitors in good working order? Ajo - *%j , . <br /> x5. Do all of the electronic gauges and alarms work properly?W _,5e� <br /> (6. Are all of the fill pipe collars in place? Ye_s <br /> fl. Are all of the tanks properly. labeled? If-es <br /> x8. Are all of the fill . boxes clean and empty of water? t 'x.5 <br /> )(9. Are all of the monitoring wells securely locked? Ycs <br /> r10. Do all of the dispensers have the proper water resistant .f11ters7Yas <br /> X11. Do the floats on the overfill prevention systems work properly? y% - <br /> x12. Is there a tank plate at the bottom of fill tube? Ye_s <br /> 1e13.. Is the fill length within tolerance? (6-3/4 i nches) N O * -Z <br /> rl4. Are there any observation wells Present? y�S <br /> x15. Do all of the observation wells have caps? �-aS <br /> ? 16. what is general condition of sub pump and leak detector area? —auj c/ <br /> Is it aperati onal ? y-..s <br /> ,r17 . Are sump sensors in place? yes <br /> f/r a.� lc�.s s c,.c.ws a-ye_ w�(�c� •�.. >@r(J �► 4 ,6 (.� �,'" <br /> s' 7L <br /> r <br />