Laserfiche WebLink
FEB -1? -2011 16:24 Service Station Systems 408 938 8888 P.05 <br />Monitoring System Certification - Page 3 of 3 <br />Site Address: 35 N. Cherokee Ln. Date of Testing/Servicing; 9120111 <br />F. In - Tante Gauging / SIR Equipment: a Check this box if tank gauging is used only for inventory control. <br />R 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 Ieak detection monitoring. <br />Comnlete the following checklist: <br />❑ Yes <br />0 No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />0 Yes <br />❑ No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />❑ Yes <br />❑ No* <br />Was accuracy of system product level readings tested? <br />❑ Yes <br />❑ No* <br />Was accuracy of system water level readings tested? <br />0 Yes <br />1 ❑ No* <br />Were all probes reinstalled properly? <br />❑ Yes <br />0 No* <br />Were all items on the equipment manufaeturces maintenance checklist completed? <br />* In Section H below, describe how and when thcsc dcttcienctes were or will oe corree[ce. <br />G. Line Leak Detectors (LLD): l7 Check this box if LLD's are not installed. <br />VVlF! FV.'V <br />a Yes <br />- <br />a No* <br />For equipment start -tip or annual equipment certification was a leak simulated to verify LLD performance? <br />❑ N/A <br />(Check all that apply) Simulated leak reate: a 3 g.p.h. (1.); p 0.1 g.p.h. (2.); ❑ 0.2 g.p.h. (2). <br />Notes: 1. Required for equipment start-up certification acid annual certification. <br />2. Unless mandated by local a one ., certification required oaly for electronic LLD start -g. <br />a Yes <br />El No* <br />Were all LLD's confirmed operational and accurate within regulatory requirements? <br />a Yes <br />a No* <br />Was the testing a aratus ro €71 calibrated? <br />M Yes <br />❑ No* <br />For mechanical LLD's, does the LLD restrict product flow if it detects a leak? <br />0 N/A <br />O Yes <br />❑ NO <br />For electronic LLD's, does the turbine automatically shut off if the LLD detects a leafs? <br />a N/A <br />❑ Yes <br />0 No* <br />For electronic LLD's, does the turbine automatically shut oft' if any portion of the monitoring system is disabled <br />0 N/A <br />or disconnected`? <br />0 Yes <br />❑ No* <br />For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system <br />a N/A <br />malfunctions or fail.4 a test? <br />❑ Yes <br />0 No* <br />For electronic LLD's, have all accessible wiring connections been visually inspected? <br />a N/A <br />a Yes <br />0 No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In Section H below, describe how and when these deficiencies were or will be corrected. <br />H. Comments: _ _ <br />