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-Jan. 23. 2006 1 .21PMW Star Environmental, Inc. No. 6876 P 4 <br /> r. lea-.Lur n vuugtng l S.2utyiuGuc. UN L1+eck this box gauging as usou only iui niventory contra�l <br /> 13 Check this box= ^o ga=«ging or SM equipment is insta!le <br /> This section trust be completed if in-tank gauging equipment is used to perform leak detection monitoring. <br /> Complete the NO ina checklist: <br /> ff <br /> ❑ o Has ail input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> ere tan gauging Pro visua ly anspect or mage andres, ue buy up❑ o as accuracy of system product eve rea ings teste . w <br /> * Yes ❑ o f Was accuracy nf system water level res mgs testeV. <br /> U ❑ o Were all probes reinstalled properly? <br /> ❑ ® Were all items on the equipment manufacturers Fa checklist comp ete ? <br /> e Section h4 below,describe ow an wen Ifiese denciencies were or will be corrected. <br /> G. Line Leak Detectors(LLD): ❑ Check this box if LLDs are not installed. <br /> complete the fOU0 ing checklist: <br /> ® Yes p o For equipment start-up or annual equipment certification,was a leak simulated to ver,y LLD j0iiancf�? <br /> . <br /> ❑ NIA (Check all that apply)Simulated leak rate; 0 3 g.p h.; ❑0. 1 g.p.h. ❑0.2 g.p.h. <br /> 10 Yes ❑ o Were-all LLDs confirmed operational and accurate within regulatory requirements? <br /> ® Yes ® o as a testing apparatus properly c t rat <br /> l4 Yes Cl NU For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> ❑ NIA <br /> ❑ Yes ❑ o For electronic LLDs,does the turbine automatically shut off if the LID detects a GO <br /> ® N/A <br /> Yes For a eetron'c s, oes t e to me automatically shut off if any portion of the m6ftorEg system,s ass <br /> IM NIA or disconnected? <br /> ❑ Yes o For electronic LLDs, oes e m ,ne automatically shut off if any portion of the monitoring system mal 'oi <br /> /A or fails a test? <br /> ❑ Yes 0 For electronic LL s, veessi a wiring connections been visually inspected? <br /> 10 NIA <br /> IN Yes 10 o Were all items on the equipment man cturer s maintenance ch-RUR comp etc . <br /> In the Section 11,below, escre a 5ow goia when these deficiencies were or will be corrected. <br /> H. Comments: <br /> Page 3 of 4 03/01 <br />