COMPLIANCE INFO_2017-2018 - Laserfiche WebLink

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In Section H below, describe how and when these deficiencies were or will be corrected. G. LINE LEAK DETECTORS (LLD): ❑ Check this box if LLDs are not installed. Complete the following checklist: Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? El N/A (check all that apply) Simulated leak rate: 3 g.p.h.; El 0.1 g.p.h.; El 0.2 g.p.h. ■ Yes ElNo* Were all LLDs confirmed operational and accurate within regulatory requirements? El Yes ElNo* Was the testing apparatus properly calibrated? ■ Yes El No * For mechanical LLDs, does the LLD restrict product flow if it detects a leak? El NIA ❑ Yes ElNo* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ■ N/A El Yes ElNo* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled ■ N/A or disconnected? El Yes ElNo* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions ■ N/A or fails a test? El Yes El No * For electronic LLDs, have all accessible wiring connections been visually inspected? ■ N/A ■ Yes ElNo* Were all items on the equipment manufacturer's maintenance checklist completed? In Section H below, describe how and when these deficiencies were or will be corrected. ❑ Yes ❑ Sall" 7 MONITORING SYSTEM CERTIFICAW*'_�, CERTIFICATION/ TEST DATE: June 9, 2017 A1. FACILITY Name Quik Stop Market #125 Address 1580 W. Main Street, Ripon, CA 95366 Phone # 510-657-8500 Contact Roger Batra A2. OWNER Name Quik Stop Mar �,1h_o r , Address 4567 Enterprise Street, Fremoratr,CA �4 i38 Phone # 510-657-8500 Contact Debbie Markovich Yes ElNo* Were all tank gauging probes visually inspected for damage and residue buildup? El Yes ElNo* F. IN -TANK GAUGING / SIR EQUIPMENT: N 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 gaugung equipment is used to perform leak detection monitoring. Complete the following checklist: El Yes ❑ No* Was accuracy of system water level readings tested? El Yes ❑ No * Were all probes reinstalled properly? _ El _ Yes ElNo* Were all items on the equipment manufacturer's maintenance checklist completed? * " H. COMMENTS ❑ Yes ❑ No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? El Yes ElNo* Were all tank gauging probes visually inspected for damage and residue buildup? El Yes ElNo* Was accuracy of system product level readings tested? El Yes ❑ No* Was accuracy of system water level readings tested? El Yes ❑ No * Were all probes reinstalled properly? _ El _ Yes ElNo* Were all items on the equipment manufacturer's maintenance checklist completed? © 2017 Walton Engineering, Inc Page 3 of 3