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0 <br />Facility Name: Costco # 1003 Woodland (Page 3) <br />In -Tank Gauging: <br />0 <br />®Check this box if tank gauging is used only for inventory control and disregard following section. <br />C'mmplete the fnilowinn checklist: <br />❑ Yes <br />❑ No* <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 />Ll 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 />L❑ <br />❑ No* <br />Were all probes reinstalled properly? <br />-No * <br />Were all items on the equipment manufacturer's maintenance check=list completed? <br />* In the Section 11, below, describe how and when these deficiencies were or will be corrected. <br />G. Line Leak Detectors (LLD): <br />❑ Check this box if LLDs arc not installed and disregard the following section. <br />® Yes <br />❑ No* <br />For equipment start-up or annual equipment certification, was a leak simulated to verife LLD perl'Ormanc:e? <br />❑ N/A <br />Wheck all that applyy applySimulated leak rate: ❑ 3 h.; [10. 1 h ; ❑ 0.2 gph. <br />® YesNo* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />® Yes <br />Duh <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 />El No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak'? <br />❑ N/A <br />® Yes <br />El 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 />El 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 />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In the Section Fl, below, describe how and when these deficiencies were or will be corrected. <br />H. Comments: <br />