COMPLIANCE INFO_2016 - 2018 - Laserfiche WebLink

Home Browse Search

MONITORING SYSTEM CERTIFICATION __ CERTIFICATION /TEST DATE: May 26, 2016 Al. FACILITY A2. OWNER Name 7 -Eleven Market #2368/ Store #17647 Name 7 -Eleven, Inc � -1•„, �rr6' Address 1046 West Yosemite, Manteca, CA 95336 Address P.O. Box 711, Dallas, TX 75241 • l'� •� - Phone# 209-239-2329 Phone # 605-523-2949 Contact Stephen Boyd Contact Stephen Boyd F. IN -TANK GAUGING / SIR EQUIPMENT: ■ Checkthis box if tank gauging is used only for inventory control. ❑ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in -tank gaugung equipment Is used to perform leak detection monitoring. Complete the following checklist: ❑ Yes ❑ No ` Has all input wiring been inspected for proper entry and termination, Including testing for ground faults? ❑ Yes ❑ No • were all tank gauging probes visually inspected for damage and residue buildup? ❑ Yes ❑ No • Was accuracy of system product level readings tested? ❑ Yes ❑ No Was accuracy of system water level readings tested? ❑ Yes ❑No' Were all probes reinstalled properly? I• ElYes ❑ No Were all items on the equipment manufacturer's maintenance checklist completed? In Section H below, describe how and when these deficiencies were or will be corrected. G. LINE LEAK DETECTORS (LLD): ❑ Check this box if LLDs are not installed. Complete the following checklist: ❑ Yes ❑ No For equipment start-up or annual equipment certification, was a leak simulated to verity LLD performance? ❑ WA (check all that apply) Simulated leak rate: ■ 3 g.p.h.; ❑ 0.1 g.p.h.; ❑ 0.2 g.p.h. ❑ Yes ❑ No' Were all LLD* confirmed operational and accurate within regulatory requiremems? ❑ Yes ❑ No • Was the testing apparatus properly calibrated? ❑ Yes ❑ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ❑ WA ❑ Yes ❑ No' For electronic LLDs, does the turbine automatically shut off N the LLD detects a leak? ❑ WA ❑ Yes ❑ No . For electronic LLDs, does the turbine automatically shut off N any portion W the monitoring system Is disabled ❑ WA or disconnected? ❑ Yes ❑ No • For electronic LLDs, does the turbine automatically shut off N any portion of the monitoring system malfunctions ❑ WA or falls a test? ❑ Yes ❑ No' For electronic LLDs, have all accessible wiring connections been visually inspected? ❑ WA ❑ Yes ❑ No ` Were all items on the equipment manufacturer's maintenance checklist completed? In Section H below, describe how and when these deficiencles were or will be corrected. H. COMMENTS Page 3 of 3