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F. In -Tank Gauging / SIR Equipment: ❑ Check this box if tank gauging is used only for invent-eontio'] <br />El Check this box if no tank gauging or SIR ent is installed. <br />This section must be completed if in -tank gauging equipment is used to perfor detection monitoring. <br />Complete the following checklist: <br />❑ Yes <br />❑ No* <br />Has all input wiring been inspected for proper e and termination, including testing for ground faults? <br />❑ Yes <br />❑ No* <br />Were all tank gauging probes visually i cted for damage and residue buildup? <br />❑ Yes <br />❑ No* <br />Was accuracy of system produc el readings tested? <br />❑ Yes <br />❑ No" <br />Was accuracy of systempff err level readings tested? <br />❑ Yes <br />❑ No* <br />Were all probes r' tailed properly? <br />0 <br />❑ N/A <br />rrs on the equipment manufacturer's maintenance checklist completed? <br />Ill LUG .7GL,LIVII u, ✓UL�I l U"" IUG UUW U"u wuujj Luc= ucimieucies were or will De corrected. <br />G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />Comnlete the. fnlinwina ehPelcliet- <br />Yes <br />❑ No* <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: g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. <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 />❑ N/A <br />Cl Yes <br />❑ 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 />El 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 />El N/A <br />Yes <br />El <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In the Section <br />H. <br />below. describe how and when thecP fdPfiPiPnPira wnrn , .:.al L.,. ..,._._._._a_a <br />H. Comments: <br />Testing Company Name: TANK -TE EtN, VIRONMENTAL <br />Site Address: I �i� 1 W • CY )a r +er V\ <br />6a Phone No.: (707 L 446-6151 <br />to of Testing/Servicing:/ 1 <br />Page 3 of 3 03/01 <br />