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sr_ F "s 04 361 ff da Test (20S) 744-0116 P"4 <br />7 <br />531 <br />�a tc 4Dr I <br />7( <br />nt: <br />SER EqUjP'InL 6(Check this box if gzuging 's us,.t for <br />C3 Check this box if no tank gau"'i"'Igfy or equipm'-_'I" i_s i7l";`allod. <br />This s­_ciion niuv, be coiiiPlf-ted If hl-tarlk gUlgillg CqUjpnjCjjt j� used to perf I a e C 011 <br />.orrn Ic k d "e, ti <br />and residue buildup? <br />No" f Wa� ElcJ ruracy of sylte <br />- i7� <br />CY fsy <br />M N'.0" <br />mereI ixobc.3 reinstalled properly? <br />ars t <br />Avare al; itcaDTz or d7c �qulpmentmanufhcturcr's maintenanca clic:cklisit <br />";uuO wiles] thesed0ficiencies were or wilt liq�' �Corrected. <br />Une Le;zkD-inectors (LLD). 0 Check this box if LLDs arc riot installed, <br />1 <br />Fb7 ecmpm- <br />zt 5tar_ItF, or annual equipment ccrtification, was a, leak simulate <br />'/effy LLD, p <br />F -J Simulated leak rate: X3 9.p..; 00.1g.pzh, Qo_2;3,.p.h, <br />"re a"l �I'L'53 ;on firm ;d—O-PeiZonal and �accuraic within regulat— <br />OTY requirements? <br />`Cs i " ttis i—"Ppycarate7 <br />Or _Mecki-MO-cTI ULDs, Oes flee LLD restrict product ow if it 'detacis a 1,,,,ik7 <br />LU)S' d;Aes t U ine automatically shut off if the -E-5 _13�ie_CEIZI I <br />Q Y"'� ore, <br />IIWA <br />mss "C, R For elecromc UDs, du�7s the turbine <br />'o i- d - sc 01, a P4 0­4�" d I aulamaticzilly shlit off if any portiogi of the nzqn:?!� , OTAng 3yvtem is�' diist"hl <br />WA <br />571ne �autematically shut Off F—i"Cl <br />Y"7: Ne"; U,Ds, does the tur <br />Y poa toss f thV rr n€t. HT1.71 <br />or Eils a fest? <br />F`J <br />,qFVcessi <br />L, all tic ble wiring Conflections �_cen _viz�ua]Fy 7us—pi-c—tea? <br />wth <br />No etc all —itini tin Ti_,-7—qugpgnm manuracturer,,5 Inaintenanm checki <br />dcscri <br />Uirliciencies were orwill be ovrrerted. <br />