COMPLIANCE INFO_1998 - 2004 - Laserfiche WebLink

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Site Address, �••� F: [n-Tank Gauging/SIRE ,'Dere of Tcsting/Scrwicing: ai --�- q prntnt: Check this box if tattleau in 8 $ g is used Only for Inventory canirol. Check this box if no tank gauging or SIR equipment is in9talicd. ThIs sectian must be completed if in-tank gauging equipment is used to perforin leak detection Monitoring.Complete the tollawin cltetldJst: Yes ❑ No* Has all input wlriug been inspected for proper entry and termination,including testinf Yes El No* Were all tank gouging probes visually inspected for damage and residue buildup? g or ground faults? Yes O No* Was accuracy of systern product le v:L readings tested? Yes O No* Was accuracy of system water level readings tested? Yes 17 No* Wtre all prolx�reirtstalicd properly? 4 Yes © No* Were all it M9 on the equipment ntanufacrurer'sroaintenance checklist complateci:� Seciiatl H,below,describe hoar and rettcn these dellciencies wart or will be evrrecred. G. Line Leak Detectors (LLD)- U Check this box if LLDs are not installed. Complete the following checklist: Yes ❑ No* For equlpmrnt siert-up or annual equifit eertifcRrion, was a leak ulated to verify LLD txrforrnance? ❑ MA (Check all that apply) Siruulated leak ratpme 3 g.p.h.'; G Q.I g.p,h,'; ❑0.2 8.p.11.' Notes: 1, Required for equiptnent start-up ecrhfication ind annual certification. 2. Unless trlarrdated by local agency,certification required only for electruric LLD start-up. U Yes No* Were all LLDi confirmed operational and acc;traie radia regulatory requirements'' Yee ❑ No* Was t6ie testing apparatus properly calibrated? U Yes A No* For mechanical LLD) ,does the LLD restrict product flow if it detects a leak? -� O NIA ❑ Yes ❑ No* For electronic LLDs,docs the turbine autorrtaticaily shut ofl ii the LLD detects a leak'? N/A f Yee ❑ No* For electronic Lips,does the turbine,automatically s11ut off if any portion of the nlonftoring system is disabltd S� N/A or disconnected'? J Yes a No* For electronic LLDs, does the turbine autocratically shat off if any portion of the monitoring system N/A maifuncdons or fails a test? 0 Yes ❑ No* For electronic LLDs,have all accessible wirutg con,rections been visually inspectcd7 N/A Yes ;a No* Were all items on the equipment manufacturer's maintenance checklist completed? • In the Section 11,below,describe how and where these deficiencies were or will be corrected. H. Comments: �.1� �� �i�c 44/1 CALM-{t Page 3 of t 1115199;