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JUN-26-2708 17: 17 Service Station Systerns 408 938 8888 P.05 <br /> Monitoring System Certification- Pal A3 <br /> Site Address: 2448 W. Kettleman Ln.@ Lower Sacramento ^_ Date of Testing/Servicing: 5/28108 <br /> F. In - Tank Gauging/SIR Equipment: ❑ Check this box if tank gauging is used only for inventory control. <br /> 0 Check this box if no tail-gauging or SIR equipment is installed_ <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. <br /> Com tete the foliowin checklist: <br /> 18 Yes ❑ NO Ilas all input wiring been inspected for proper entry and termination, including testing for ground faults? <br /> ig Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> CK Yes ❑ No* Was accuracy of system product level readings tested? <br /> M Yes ❑ No* Was accuracy of system water level readings tested? <br /> rX Yes ❑ No* Were all probes reinstalled properly? <br /> 11 Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> In Section H below,describe how and when these deficiencies were or will be corrected. <br /> G. Line Leak Detectors(LLD): p Check this box if LLD's are not installed. <br /> Com tete the folio ing checklist; <br /> CK Yes ❑ No* Por equipment start-up or annual equipment certification was a leak simulated to verify LLD performance? <br /> ❑ N/A (Check all that apply) Simulated leak reate:[K 3 g.p.h. (I_); ❑ 0.1 g.p.h.(2.); ❑ 0.2 g_p.h. (2.). <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 /> t$Yes ❑ No* Were all LLD's confirmed operational and accurate within regulatory requirements? <br /> IS Yes ❑ No* Was the testin apparatus properly calibrated? <br /> 13 Yes ❑ No* For mechanical LLD's,does the LLD restrict product flow if it detects a leak? <br /> ❑ N/A <br /> ❑ Yes 11 No* For electronic LLD's, does the turbine automatically shut off if the LLD detects a leak? <br /> N/A <br /> ❑ Yes ❑ No* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> CK N/A or disconnected? <br /> 11 Yes ❑ No* For electronic I.LD's, does the turbine automatically shut off if any portion of the monitoring system <br /> 1$ N/A malfunctions or fails a test? <br /> ❑ Yes Q No* For electronic LLD's, have all accessible wirintr connections been visually inspected? <br /> C1 N/A <br /> 18 Yes 1 Q No* Were all itenns on the equipment manufacturer's maintenance checklist completed? <br /> *In Section H below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: Replaced 91 LLD, tested okay <br />