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Jan 03 07 04:19p AfOrda Test (209) 744-0116 p.4 <br />Site Address: ���Q CM _.f:�r .E F' E , QCs(; i c of-Testing/Servicing' /0/-::,- <br />F. <br />O/F. In -Tank Gauging /SIR Equipment: Check this box if tank gauging is used only for invcntory'control. <br />Ll Check this box if no tank Zauging or SIR equipment is installed. <br />This section must be completed if in -tank gUlging equipment is used to perform leak detection monitoring. <br />ConlDlete the followinLv checklist: <br />❑ Yes <br />❑ No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />D Yes <br />D No* <br />Were all tank gauping probes visually inspected for damage and residue buildup? <br />Q Yes <br />4 No* <br />Was accuracy of system product level readings tested? <br />Cl Yes <br />'0 No* <br />Was accuracy of systern water level readings tested? <br />❑ Yes <br />❑ No* <br />Were a]I probes reinstalled properly? <br />❑ Yes <br />d No* <br />Were all items on the equipment manufacturer's maintcnancc chccklist completed? <br />• In the Section 1.1, below, describe Crow and when these Octrcicncies were or will be corrected. <br />G. Line Leak Detectors (LLD): Ci Check this bas if LI_Ds are not installed. <br />Com to the foljowing checklist: <br />lz—Ycs NO` For <br />I <br />L Comments: 7 ®G7 G,/1-� �1L l CSI) 3 6W�7 <br />O N/A <br />equipment shirt -up or annual equipment cert -ation, was a leak simulated to verify LLD performance? <br />(Check all drat apply) Simulated leak rate: g.p.lt.; ❑ 0.1 g.p.h ; O 0.2 g.p.h. <br />Eryes <br />O No* <br />Wcrc all LLDs confirmed operational and accurate within regulatory requirements? <br />Ej Y s <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />Yes <br />❑ No* <br />❑ NIA <br />For mechanical LLDs, does the Ul) restrict product flow if it detects a leak? <br />:1 Yeo <br />❑ o` <br />N/A <br />For electronic LLDs, docs the turbine automatically shut off if the LLD detects a Ieak7 <br />3 Yes <br />C1 o` <br />N/A <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />or disconnected? <br />:1 Yes <br />❑ No• <br />N/A <br />For electronic LLDs, docs the turbine automatically shut olT- if any portion of the monitoring system <br />malfunctions or fails a test? <br />es <br />LYe <br />13No* <br />N/A <br />For electronic LLDs, have all accessible wirinG connectians been visually inspected?,1 <br />s <br />❑ No* <br />Were all items on the equipment manulacturer's maintcnancc checklist completed? <br />In the Section H. <br />below. describe how and when these deficiencies were or will be corrected. <br />L Comments: 7 ®G7 G,/1-� �1L l CSI) 3 6W�7 <br />