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JUL-03-2902 14:37 SOUTHLAND CORP NW DIV. 503 977 7711 P.16i16 <br /> Nloing Syetem CartHlcatlon <br /> site Addims: 4B4J S.KINGSLEY(FRONTAGE RD) _ rareel TaelinWSavicII:_Q`u/14�0-OZ <br /> _HWY 99®ARCH AIRPORT RD _ <br /> F. In-Tank Gauging l SIR Equipment z❑ Chock this box if tank gauging is uoea only for irwsntory wri <br /> ❑ chuck ilia box If no lank geugog or SIR equipment le meaull <br /> This section must he complutad if in-tank aauging equipment Is used ti,perform leak detection monitoring. <br /> Complete the following chackltar <br /> ❑Yes []No- Has all mputwldw bnmrkvpeotedfor prcparantry and wrrrunallm.Including testae for groundteults? <br /> Dyya ❑Ne. Were all lank g.uek,g probes visually Inspected lot damago and residue buildup? <br /> ❑Yea ❑Ne• W%SA¢Jwcy of Ayalon prowbl level roodln9a tasted? <br /> Yaa ❑Na• was accuracy of system water larval roadinge lemad? _ <br /> V00 Na• were on proboe reinowen prwrly7 _ <br /> ❑Yoe ❑Ne- Wcro all itomc on me equipment menuracermm'rntmransnca Mecbaal wulplaWd? <br /> 'In ttw octan H,billow,datenao now aM WW rhaae OellCIME*a Wei a w will be waocmd, <br /> G- Line Leak Batectars(LLD) : pwaK NIS bo%Ill r nc we nm kedwad. <br /> Complats the feliewmg chileleierl <br /> For oquipmml olan-up or annual equlpmem rxemikallmr,was a Imk simulated b vai LLD performance? <br /> Q Yac ❑Na• QNiA (Cdwuk all 0 led eguld Simulated leek rob; M 39-Fh❑u.1 g.p.n ❑0.2 g.pn <br /> z Gas sl,' Wino all LLDe wnfamed apcmliomal ono wwwraw Winn regulatory roniumarwnlx? <br /> N Yst LJllo• Wile me taeung apparatus properly-Iwai ad? <br /> Veil r]Ne• MMA for msensiutsl ues,does n,. n rt^Jriru wfAlualtlaw A it dskota o look? <br /> ❑s yex ❑NGt ❑WA I,er Uiu„LLLD3.dose the turbine oalamedeally shut elf iF w LLO dawns a uas9 <br /> ❑z Van ❑Ns• ❑MA For aloalrvrvc 10a,dodo mewrbino automatically Mui on It any pmmnn m rhe rronlfodnp aysWnia Jiaablaf erdiawMeatod7 <br /> Yaa rINu' ❑WA For swcumuc Ll.nx Geon ll,n haLia6 aubmaliwlll shut b6 a any potion of monitoring eyswm iffair.inninna MMILS a taxi <br /> ET <br /> nice ❑No• ❑wA <br /> For alecG wdu LL03,have all accoesibk wifing connections oval,uicusay Inspected? <br /> (]Yes ❑Nv' Were all nems on me equipment rwllrtartruer%malnlenauw claddlsi sompbted? <br /> •In the Soegen H.blow,describe how and when gross donolonoas were of will be coneaeo. <br /> H. Comments: <br /> Mgchoel I--glia <br /> Jct cel,u nAMO-5505 <br /> Come Lic#743160 <br /> .. page 3 of 3 ... ... <br /> TOTAL P.16 <br />