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Site Address: 2133:2908 BENJAMIN HOL:0,CA 95207 Date sting/Servicing: 73qWC <br /> F. In-Tank Gauging f 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 completed if in-tank gauging equipment is used to perform leak detection monitoring. <br /> Complete the foll1a, ing checklist: <br /> V ' No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> MNo* Was accuracy of system product level readings tested? <br /> No* Was accuracy of system water level readings tested? <br /> Yes JV, No* Were all probes reinstalled properly? <br /> Yes M 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 corrected. <br /> G. Line Leak Detectors (LLD): Check this box ifLLDs are not installed. <br /> Com the follow' checklist: <br /> iffes No* For equipment startup or annual equipment ceAification, was a leak simulated to verify LLD performance? <br /> NIA (Check all that apply) Simulated leak rate: g.p.h.1; 110.1 g.p.h.2; M 0.2 g.p.h.a <br /> Notes: 1. Required for equipment startup certification and annual certification. <br /> 2. Unless mandated by local agency,certification required only for electronic LLD startup. <br /> No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> e No* Was the testing apparatus properly calibrated? <br /> es No* For mechanical LLDs,does the LLD restrict product flow if itdetects aleak? <br /> NIA <br /> es No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> NIA <br /> es No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> NIA or disconnected? <br /> es No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br /> NIA or fails a test? <br /> Yes No* For electronic UDs,have all accessible wiring connections been visually inspected? <br /> NIA <br /> es 0 No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> *In the Section H,5elow,descrilbe how and when these deficiencies were or will be corrected. <br /> H. Comments: <br /> i <br /> i <br /> Page 3 of 3 03,01 <br />