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Site Address: 907 LINCOLN ROAD,-STOCKTON 139aof Testing/Servicing: 8/12/03 <br />t F. In -Tank Gauging / SIR Equipment: ® Check this box if tank gauging is used only for inventory <br />control. <br />❑ 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 leak detection monitoring. <br />1.V111 1OL0 LLc 1VL-V <br />® Yes ❑ No* <br />vo . <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />® 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 />® Yes <br />❑ No* <br />Were all probes reinstalled properly? <br />® Yes <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In the Section H, below, describe how and when these deficiencies were or win ne correcieu. <br />G. Line Leak Detectors (LLD): ® Check this box if LLDs are not installed. <br />l.Vlll le Lc <br />❑ Yes <br />Ldl6 IVlIV ♦Y <br />❑ No* <br />laB <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br />❑ N/A <br />(Check all that apply) Simulated leak rate: ❑ 3 g.p.h.1; ❑ 0.1 g.p.h.2; ❑ 0.2 g.p.h.2 <br />Notes: 1. Required for equipment start-up certification and annual certification. <br />2. Unless mandated by local agency, certification required only for electronic LLD start-up. <br />❑ Yes <br />❑ No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />❑ Yes <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />❑ Yes <br />❑ No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />❑ N/A <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />[I N/A <br />El Yes <br />E] No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />❑ N/A <br />or disconnected? <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system <br />❑ N/A <br />malfunctions or fails a test? <br />❑ Yes <br />❑ No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />❑ N/A <br />❑ Yes <br />El No- <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In the Section H, below, describe how and when these deficiencies were or win De correcrea. <br />H. Comments: <br />