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Site Address: 6100: 25775 S PATTERSON ' SS,CA 95376 Date -`TestinglServicing: 3�d <br /> . F. In-Tank Gauging/ SIR Equipment: /`� Check this box if tank gauging is used only for inventory control. <br /> b Check this box if no tank gauging or SIR equipment is installed. <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitorng. <br /> Complete the following checklist: <br /> Q Yes 10 No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> p Yes Q. No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> n Yes (] No* Was accuracy of system product level readings tested? <br /> 7 Yes j No* Was accuracy of system water level readings tested? <br /> Yes [3 No* Were all prob e s reinstalle d prop erly? <br /> Yes Q No* I 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 willbe corrected. <br /> G. Line Leak Detectors (LLD): Check this box if LLDs are not installed. <br /> Com to the following checklist: <br /> es El No* For equipment start-up or annual equipment c cation, was a leak simulated to verify LLD performance? <br /> b NIA (Check all that apply) Simulate d leak rate: ' <br /> g.p.h.l; 0 0.1 g.p.h.2; (]0.2 g.p.h? <br /> Notes: 1. Required for equipment start-up certification and annual certification. <br /> 2. Unless mandated by local agency, certification required only for electronic LLD start-up. <br /> e p No* Were allLLDs confirmed operational and accurate within regulatory requirements? <br /> es p. No* Was the testing apparatus properly calibrated? <br /> } Yeso* Formechanicall-LDs, does the LLD restrict product flow if it detects aleak? <br /> �IA <br /> YesNo* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> 0 NIA <br /> trl; No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> N. NIA or disconnected? <br /> —WYes '1 No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br /> NIA I or fails ate st? <br /> es Q No* For electronic LI-Ds,have all accessible wiring connections been visually inspected? <br /> NIA <br /> es l] 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 willbe corrected. <br /> H. Comments: <br /> Page 3 of 3 0341 <br />