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site Address: 2093:3425 TRACY BLVD Y CA 95376 <br /> F. In-TankGan&gISMEquipment Check this box if tank gauging is used only for inventory control. <br /> Check this box ifno tank gauging or SIR equipment is installed. <br /> This section must be compl d if in- gauging equipment is used to perform leak-detection monitoring. <br /> conwkisthe fo clm <br /> Yes M, No* Has allinput been acted for proper entryrmination,including testing for ground faults? <br /> Yes In No* Were all tank gauging probes y inspected2=— een—dresidue buildup? <br /> Yes No* Wuaccuncyofsystem product leve gstested? <br /> Yes No* Was accuracy of system water lov a ' sled? <br /> Yes 111 No* Were all probes reiwtallod edy? <br /> Yes of No*,,,,l Were all ittms on th acturer's m ' n e checklist completed? <br /> k <br /> In 60 Sedbx H,below,descrs7►e ow and when dwee deffc fes won or whIke corrected. <br /> G. Line Leak Detectors (LLD): Check this box if LLDs are not installed. <br /> Co hate the c ° t: <br /> jV Yes No* For equipment start-up or annual equipmcertification, a leak simulated to verify LLD p e? <br /> NIA (Check nit that apply) Sim d leak rate: 3 g.p.h.1; 10.0.1 g p.0; SO.2 g.p.h.2 <br /> Notes: 1. Required for equipment up ertificatioa Aud annual certification. <br /> 2. Unless mandated by local agency,certification required only for electronic LLD start-up. <br /> Yes No* Were all LLDs comirmed operational and accurate within reguistory requirements? <br /> Yes No* Was the testing apparatus properly calibrated? <br /> Yes No* For mechanical LLDs,does the UDrestrict product flow ifitdetects aleak? <br /> N/A <br /> Yes No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> N/A <br /> Yes No* For electronic LLD9, does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> N/A or disconnected? <br /> Yes No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br /> NIA or fails ate st? <br /> Yes . No* For electronic LLDs,have all accessible witing connect'connectW=been visually inspected? <br /> NTA <br /> Yes No* I Were allitems onthe equipment manufacturer's main ce checklist completed? <br /> + <br /> In tin Secdo.x H,below®describe kow and when dwe deficiencies were or vM be corrected. <br /> IL Comments: <br /> 4 <br /> Page 3 of 3 03,01 <br />