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,SS#: 6080:85 E LOUISE AVENi" ,ATHROP CA 95330 Dat Testitservicing: ;10/13/2005 <br /> F. In-T ank G auging 1 SIR Equipment. Check this box if tank gauging is used only for inventory control. <br /> Check this box if no tank gauging or SIR equipment is installed. <br /> This section must be c leted if in-tank gauging equipment is used to perform leak detection monitoring. <br /> Co fete the follow checklist: <br /> VY*e's <br /> No* Has all input wiring be spected for proper entry and to on,including testing for ground faults? <br /> No" V�Iere all tank gauging probes ally inspected f ego and residue buildup? <br /> = No* Was accuracy of system product leve gs tested? <br /> No* Was accuracy of system Ovatea readings to ? <br /> Yes A. No* Were all probes re' ed properly? <br /> Yes No* Were on the equipment manufnctuzer's maintenance ch st completed? <br /> *In the Section H,below,descrbe how and when these deficiencies were or will be carrec <br /> G. Line Leak Detectors (LLD): Check this box ifLLD s are not installed. <br /> Co M PIeIke the follow' checklist: _ <br /> Yes No* For equipment startup or annual equipment certification was a leak simulated to verify LLD performance? <br /> NIA (Check all that apply) Simulated leak rate JR3 g.ph.l; MOA g.p.h.1; 602 g.p.h.2 <br /> Notes: 1. Required for equipment stert.up certification And annual certification. <br /> 2. Unless mandated by local agency,certification required only for electronic LLD start-up. <br /> Yes No* I Were a11LLDs confirmed operational and accurate withinregulatoryrequirements? <br /> Yes No* Was the testing apparatus properly calibrated? <br /> Yes No* For mechanicalLLDs,does the LLD restrict product flow ifitdetects aleW. <br /> NIA <br /> Yes No* For electronic LLDs,does the turbine automatically shut off if the LLD detects aleck? <br /> NIA <br /> Yes No* For electronic I I Ds, does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> NIA or disconnected? <br /> Yes No* For electronic LLDs, does the turbine automatically shutoff if any portion of the monitoring system malfunctions <br /> 56 NIA or fails a test? <br /> YesNo* Far electronic LLD s,have all accessible wiring cormections been visually inspected? <br /> NIA <br /> Yes—1 No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> *In the Section H,below,describe how and when these deficiencies were or will be correcte d. <br /> K Comments: <br /> i <br /> Page 3 of 3 03MI <br />