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a Mlitoring System Certification 0 <br />Site Address: 3633 DUCK CREEK DR. @ Date of Testing/Service: 03/28/2005 <br />CFF HWY 99 @ MARIPOSA RD <br />F. In -yank Gauging 1 SIR Equipment <br />Check this box if tank gauging is used only for inventory control. <br />Check this box if no tank gauging or SIR equipment is installed. <br />This section must be completed if inAank gauging equipment is used to perform leak detection monitoring. <br />Comolete the following checklist: <br />* In the Section H, below, describe how and when these deficiencies were or will be correctea. <br />G. Line Leak Detectors (LLD) : <br />r..r...�.,a., aa.., t..tl......i.....•F.nnLlieF• <br />LJ Check this box if LLDs are not installed. <br />Yes <br />❑ Na' <br />y <br />NIA <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br />(Check all that apply) Simulated leak rate: E] 3 g.p.h E] 0.1 g.p.h 00.2 g.p.h <br />X Yes <br />l_J Yes <br />El No. <br />El No * <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Was the testing apparatus properly calibrated? <br />Q Yes <br />FINo' <br />F <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />Q Yes <br />QNo" <br />❑X NIA <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />❑ Yes <br />❑No <br />0 NIA <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br />E]Yes <br />ONO* <br />Q NIA <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? <br />El Yes <br />Yes <br />❑No <br />❑No ° <br />0 NIA <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />Were all items on the equipment manufacturers' maintenance checklist completed? <br />* In the Section H, below, describe how and when these oeticiencses were or wiu oe wlreuGcu. <br />H. Comments: <br />Page 3 of 3 Based on CA form dated 03101 <br />