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BI/0211995 03:27 2097546722 CALAVERAS EW lCALTH PaGE 03 <br />A ionitoring System Cerdneadoo f% <br />Facility Name: L IJ L <br />.siteot ;cityri �ci��� � <br />F. In -Tank Gauging Equipment: C bcck this box if tuck gauging is used only for inventory control. <br />This section must be completed if in -tank gauging equipment is used to pcTform leak detection monitoring. <br />Software Version Installed:a�3'{YZ71- <br />Complete the Following checkjW: <br />Yes <br />O No*_'Has <br />ail input wiring been Inspected for proper entry and rerminanon. including testing for ground faults? <br />Ycs <br />0 No' <br />Were all tank gauging probes visually inspected for danugc and residuc buildup? <br />KEf <br />Ycs <br />D No' <br />Was accuracy of tystcrn producdwaste Icvei readings tested? <br />gr Xes <br />Q No' <br />Was acauuy of ryrtcm water level readings tested? <br />X s <br />1] No' <br />Were ail alarms acnvamd and did they funcrion properly? <br />Yes <br />❑ Ne <br />Were all iteuts on the equipment manufacturer's Maurtcoance checkltst completed? <br />- to the -�ernort tL, txrow, aescrlbe how ani when these dchciencles were or witl be corrected. <br />G. Line Leak Detectors (LLD): <br />Complete the followiev r�herkllzt- <br />❑ Check this box if LLDs are not installed. <br />❑ Yes <br />Q No' <br />Was a leak sunulamd to verify LLD Perf0nMAUce7 (Check all char apply) <br />Sirrrulated teak rate: O 3 g_p.h.; fl 0.1 g -p. h_; 0 02 g.p. h. <br />❑ Yes <br />❑ No' <br />Were A LLDs confirmed operational and accurate within regulatory requirements? <br />O Yea <br />0 No' <br />Was rhe testing apparatus property cahbrated? <br />O Yea <br />D No' <br />For mechanical LLDs, docs the LLD restrict product flow if it detects a leak? <br />❑ N/A <br />11 Yes <br />Q No' <br />For clecuonie I.LDs, docs the turbine autornatically shut off if the LLD detects a leak? <br />D WA <br />O Yes <br />Q No' <br />For eiecuxmic LLDs, docs the turbine automatically shut oft if any pomon of the monitoring system is disabled <br />0 NIA <br />or discounecZed? <br />O Yes <br />D No' <br />For electronic LLDt, docs thr turbine automatically shut off if any portion of the mommrtng Sys:= <br />❑ NIA <br />malfunctions or fails a test? <br />❑ Yes <br />D No* <br />For eiecaanic LLDs, have all accessible wiring connections been visually inspected' <br />D NIA <br />D Yes <br />C3 No' <br />if necessary to proper equiprnrnt operation. are fuel filters in good condition' <br />O WA <br />O Yes <br />6. <br />O No, <br />Werc all items on the equipment manufacturer's maintenance checklist completed? <br />in thc,eetlOU ti, below, dtSeribe how and when these deficiencies were or will be corrrctcd. <br />H. Comments: <br />CALM 01 <br />Page <br />E -d ZbE9- T 9� (Goa) urnoje a T jje0 <br />eec:oT 6o TT unr <br />