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From.Wendell Gayer Fax:(714)5762499 To:2094883433@rcfax.con Fax: +12094683433 PageAE <br /> 8I20 6 9:11 AM <br /> ' "ED <br /> F. In-Tank Gauging/SIR Equipment. SEP 2 0i 2016 <br /> FX Check this box if tank gauging is used only for inventory contro. <br /> ❑ Check this box if no tank gauging or SIR equipment is installed <br /> ENVIRONMENTAL HEALTH <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. DEPARTMENT <br /> Complete the follo_wl checklist_ <br /> �Q No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> ❑Yes <br /> ❑Yes ❑No, 'Were all tank gauging probes visually inspected for damage and residue buildup? <br /> x�,:rcv�mewa�,� xurrr .nva .vs�rt�nrraa�nvm�¢t�t���wane�awvm�e�easv�•,nr�as�eanrsv_aaa�aY�wrrovat �vn'war+r�exws'eauma��at�a'�+nv�rnrum�,r�r+Ytiwrx�r�rs�m'renrrrrmwawexznY,wr�svm� <br /> 7Y <br /> Yes ❑No* Was accuracy of system product level readings tested?�,WARHNIN � f9ES9NM7+Y.5Y6ilJ WJAlWM7�HDdff1t7MYlYSfiYYJMIBJ.WSIA9ffi0'�Y113MD{V�'YASViXhY.4Y�f& RVA'tl5B78i3&NMYiIii�M&SIYJ"Nfi'YF]sTk7�N.WWNAIM'�.'iGSV�IIYHYiSW13T@iN.4d4YiHJlYlIA_�MN5i4IAHM�IfNAS9'YFR'1W#iWYRYMN@NF9HIf7�7�Mflf�'7hA�A9�� <br /> I ❑Yes ❑No* Was accuracy of system water level readings tested? <br /> 111,1151ITRY. (; <br /> . -----ffiYhYfl9tl46Y 'AYFIK4 Yn9PfhN&'fhB7fMYNIbWHVAE'.4�'dSkYNY9.'lRWk3YUlWr�,yfN9lA'IIAB/k79.'b�II#A 71f%Il1Y YNWMA4BYfN&1HVi1Nffi7YAAIWfiYM.4Pf9 Hi:5fNAV�07 I <br /> ❑Yes ❑No* Were all probes reinstalled properiy? <br /> ., INBSA'A'9/AIF.CL5l5'Mlrl'. - YR9MNN,RfWlRNYMI I➢hX9MAW+ elk'9idM9AffNA.T895'MHn159hV/MJYNplI>Mf8W9CG71B/MfNWP,dAk6kWeY1EPdY.W9'NN�YP'8!Y,RJiI.SSbq:41✓.F;7 NM1IF'�YR,WWAfYN%4fMk8/G�. NININRGRY!✓MA.. <br /> ❑Yes ❑No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> j1 <br /> —*In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> G.Line Leak Detectors(LLD): ❑ Check this box if LLDs are not installed. <br /> Complete the following checklist <br /> ❑X Yes ❑No* orequipment start-up or annual equipment certification,was a leak simulatedto verify LLD performance?(Check <br /> ❑N/A all that apply)Simulated leak rate: ©3 g.p.h.; ❑0.1 g.p.h; ❑0.2 g.p.h. <br /> QYes ❑No* ere all LLDs confirmed operational and accurate within regulatory requirements? <br /> X❑Yes ❑No* as the testing apparatus properly calibrated? <br /> ❑Yes ❑No* or mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> ©N/A <br /> ❑X Yes ❑No* or electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> ❑N/A <br /> I X❑Yes ❑No*v.. or electronic I.LDs,does the turbine automaticallyWshut off if any portion of the monitoring system is disabled or <br /> ❑N/A disconnected? <br /> ...�...:�a:.-:;:-: ....xsr.,c.:=.;,--�;,- �N--c'�._..;..:..__._._�..�'-. �:..wm�-.,-...-.,.Y�:.-s..:.-_:�.""-.-r:.,^-sza::.='....r.,:,:.��..-,...«:,....__�+r.�:r.-.:"...«..—:w..:W�....,r-:.�,-:..w-_.�.:•a w.-�..:.-x��a:.-m <br /> ❑Yes ❑No* or electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions cr <br /> ©N/A fails a test? <br /> ❑Yes ❑No* or electronic LLDs,have all accessible wiring connections been visually inspected? <br /> ❑X N/A <br /> �X❑ es ❑No* Were all items on the equipment manufacturers maintenance checklist completed? i <br /> In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: <br />