COMPLIANCE INFO_2007-2011 - Laserfiche WebLink

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Certification- e 3 of 3 Pa Monitoring System C` g - Site Address: 4344 Waterloo Rd late of`festin,,Servicim: F. In-Tank Gauging/SIR Equipment: ❑ Che this box if tank wising, is used onl', ti)r imenun� control. ❑ C •ck this box it'no tank gauging or Silt equipment i" im•tallcd. �l hiS section must be completed it to-tank gauging equl lent Is used to perform leak detection nionitorino Com fete the rollo in2 checklist: 0 Yes ❑ No* Ilas all input wiring been inspected r proper entry and termination. including testing tier ground faults? ❑ Yes ❑ No* Were all tank gauging probes vis Aly inspected for damage and residue buildup'! ❑ Yes ❑ No* Was accuracy of system produ level readings tested'' ❑ Yes 0 No* Was accuracy of system wat level readings tested? ❑ Yes ❑ No* j Were all probes reinstalls properly? ❑ 1'es ❑ No* Were all items on the a uipment manufacturer's maintenance checklist completed? " In Section H below,describe how and when these deficieneics were or will he corrected. G. Line Leak Detectors(LLD): ❑ Check this box if LLD's are not installed. Com fete the foliowin checklist: 7", ❑ No* For equipment start-up or annual equipment certification was a leak simulated to verify I.LI)perfi0rnnance:'0 N/A (Check all that apply) Simulated leak reate:Cf3 g.p.h.(1.); 11U.1 g,p.h.(2.): ❑ 0.2 g.p.h. (_'.). Notes: 1. Required for equipment start-up certification and annual certification.2. Unless mandated by local agency.certification required only forelectronic LLD start-up. 0 No* Were all LLD's confirmed operational and accurate within regulatuts requirements:' 9-,Yes ❑ No* Was the testing apparatus properly calibrated? ❑ Yes ❑ No* For mechanical LLD's,does the LLD restrict product flow if it detects a leak'? p-N;A i3'-Yes ❑ No* For electronic LLD's. does the turbine automatically shut off if the LLD detects a leak? 0 NIA ®'Yes 0 No* For electronic LLD's,does the turbine automatically shut off if any portion of the nronitorin,s�stenn is disabled ❑ N/A or disconnected'? Q�_Yes 0 .No* For electronic LLD's.does the turbine automatically shut off if any portion of the monitorint, system ❑ NWA malfunctions or fails a test'? (�l'c 0 No*. For electronic LLD's. have all accessible wiring connections been visualh inspected'? ❑ N/A es ❑. 40* Were all items on the equipment manufacturers maintenance checklist completed'.' v In Section H below,describe how and when these deficiencies were or will he corrected. 11. Comments: