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10/06/2011 <br />08:12 2099316743 <br />waterloo <br />Food Mart <br />#0720 P.012/015 <br />Nov 04 10 <br />07:33a Elit;r <br />v Contactors <br />120946 342 <br />p.4 <br />F. In -Tank Gauging I SIR Equipment-, 0 Check Stas bay, if tank gauging.is used only for inventory contra. <br />u Check this box it no lank gauging or SIR equipment is instaned. <br />This section must be eomplatad if in -tank gauging agutpment is used to perform leak detection monitoring. <br />CDMPiete the following checkiii-st: <br />Yes 1 0 No Has all k pui witfhg beer, inspected for proper entry and terrr+ination, including testing for ground irlts? <br />Yes 0 N Were all Sank gauging probes Asuattt inspected for -damage and residue bT1dup? <br />Yes 0 No' Wgr accuracy of syslern product Ievel readings tested? <br />Yes Na' Yuri accuracy of system mater level readings 2asied? <br />IL Yes 0 No' were ?.i1 probes reinstalled property? <br />i YesC Ali' Were all Iterrrs on the egiapmetrt marrtlfBUu efs maintenarTCE checklist costpletad? <br />>h the Sectioeii,.l�efow, deverlba herr and when those debpertcies were or wftl be corrected.. <br />G. Line Leak Detectors (LLL)): 0 Check this box if LLf?s ars nol installed_ <br />Complete the following choddist: <br />Yes 0 No'�Ztlat <br />quipment start -rep �rate., <br />eq*ment ceAificatim was a lea simulated to verify L1 D perfonnanCb? (Check s. <br />0 WAapply} Simulates te3 g.p h ; ? 0.1 g_p h ; ❑ 0.2 g_pJt_ <br />Yes . C No* Were au 11Ds corffrrmed operational and accurate wwiihhia regulatory requirements? <br />�( Yes. 0 No' Was tha testing apparath w properly calibratad? <br />L Yes o rnechanical LLDs, does the LLD restrict product flow. if It clMeets a leak? <br />NIA <br />*97 Yes j 0 No` For eiectronie tL05, does lhe tutb'tneatrtomaticatly strut off it the LLD detects 2 teak? <br />I a WA <br />rj,�YaF rt. MA, For At-*vonto LLDa, docs the ty.uy:.� autwrrgil ly sia�t uir iF any pnnxrn nr ma manitonnQ sv$tem i s ri;,ewf,r,..r ��- <br />Yes C No' Far electronic LIDS, does the turbine automatically shut ca if arty portion of the morritoring system maifunryions or <br />0 NIA faifss a tesl? <br />Yes 0 No- For electronic LLLIs, have ail accessible wiring connections been visually.insp ed? <br />o WA. <br />Yes 0 No- Were all itmrs on the equioment mancdaca,rx c fn=ntananc-chec Ji_n mo-plotpd? <br />In the 3eu4011 H, Lft* Q, desarn a Row and when these de pent:iees were or wi-ft be corrected. <br />H. Comments: <br />@-A-icrg SY -tem cerridcatton Page 3 of 4 <br />12107 <br />3 2J21/Q7 <br />