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Aug 19 03 1O: 13F Ch s.t�j Miles (209) 533-2650 p• 3 <br /> Facility: Madsen Page 3 <br /> In-Tank Gauging /SIR Equipment: <br /> ❑Check this box if tank gauging is used only for inventory control and disregard the following section. <br /> ZCheck this box if no tank gauging or SIR equipment is installed and disregard the following section. <br /> FOYes <br /> ❑ No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> ❑ No* Were all tank-gauging probes visually inspected for damage and residue buildup? <br /> ❑ No* Was accuracy of system product level readings tested? <br /> ❑ No* Was accuracy of system water level readings tested? <br /> ❑ No* Were ail probes reinstalled properly? <br /> ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> * In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> G. Line Leak Detectors (LLD): <br /> ® Check this box if LLDs are not installed and disregard the following section. <br /> ROYes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br /> ® NIA (Check all that apply) Simulated leak rate: ❑ 3 g.p.h.; ❑0.1 g.p.h ; ❑ 0.2 g.p.h. <br /> ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> ❑ No* Was the testing apparatus properly calibrated? <br /> ❑ N6* For mechanical LLI]s, does the LLD restrict product flow if it detects a leak? <br /> 0 NIA <br /> ❑Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> ® NIA <br /> ❑Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> 9 N/A or disconnected? <br /> ❑Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system <br /> 9 N/A malfunctions or fails a test? <br /> ❑Yes ❑ No* For electronic Ll.Ds, have all accessible wiring connections been visually inspected? <br /> ® NIA <br /> ®Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> * In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: leo Deficiencies. <br />