COMPLIANCE INFO_1986-2005 - Laserfiche WebLink

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- Mo itorin S to C rtifcation ri g ys m e r L v Site Address: % �i� !✓/li Date of Testing/ServicinP3 F. In -Tank Gauging / SIR Equipment: ❑ Check this box if tank gauging is used only for inventory control. ❑ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. Complete thedowing checklist: ❑ No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? ❑ Yes . Was accuracy of system product level readings tested? ❑ No* Was accuracy of system water level readings tested? Or Yes ❑ Were all probes reinstalled properly? q yes ®* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Eine Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. Co2fin1ete the following checklist: -yes- . ❑ No* . For: equipment. start-up or annual equipment certification, was a leak simu -to verify LLD performance? ❑ NIA (Check all that apply) Simulated leak rate: ❑ 3 gph'; . El0.1 g-pl!-010.2 g.ph2 Notes: 1. Required for equipment start-up certification and annual certification. -. 2.. Unless mandated by local agency, certification required only for electronic LLD start-up. No* Were all LLDs confirmed operational and accurate within regulatory requirements? 1❑ ❑ No* Was the testing apparatus properly calibrated? Yes (3 No* For mechanical LLDs; does the LLD restrict product flow if it detects a leak? ❑ N/A ❑ Yes ❑ N or electronic LLDs, does the turbine automatically shut off if the LLD detect a leak? NIA ❑ .Yes ❑ For - electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled Gj'N/A or disconnected? ❑ Yes ❑ *' For electronic LLDs, does the turbine automatically shut off if any -portion of the monitoring system 7;'-;A malfunctions or fails a test? ❑ Yes O For electronic. LLDs, have all accessible wiring connections been visually inspected? A ' ❑ 'Yes 93 No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. IL Comments: