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Site Address:76696A5 E LOUISE AVEN' ATHROP,CA 95330 De Tastin — ervici ' G <br /> F. In-Tank Gauging; SIREgnipment: Checkthisboxiftankgaugingisusedonlyformventorycontrol. <br /> Cl.eck 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 monitoring;. <br /> Cc Mp Tete the fe lloing checklist: <br /> t. Yes , No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> ],Yes ] No* Were alltank gaugingprobes visually inspectedfor damage and residue buildup? <br /> Yes No* Was accuracy of system product level readings tested? <br /> 13, Yes No* Was accuracy of system water level readings tested? <br /> Yes No* Were all probes reinstalled properly? <br /> 15 Yes El No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> *Ix the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> G. Line Leak Detectors (LLD): Check this bcx if LLD are not installed. <br /> Co to the following checklist: <br /> Yeo No* For equipment start-up or annual equipment c—pedfication, was a leak simulated to verify LLD performance? <br /> NIA (Check all that apply) Simulated leak rate: 21 g.p.h.l; [d 0.1 g.p.h?; M 0.2 g.p.h 2 <br /> Notes: 1. Required for equipment start-up certification and annual certification. <br /> 2. UrAess mandated by local agency,certification required only for electronic LLD start-up. <br /> fif YV No* Were a11LLDs confirmed operational and accurate within regulatory requirements? <br /> >re No* Was the testing apparatus properly calibrated? <br /> 017 eso* FormeheniealLLD s, doas the LLD re strict pro duct flow if itdetects aleaV? <br /> NIA <br /> Yes * For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br /> N <br /> EIA <br /> E <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> F/A or disconnected? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br /> FNIA or fails ate st? <br /> For electronic?1 Ds,have all accessible wiring connections been visually inspectad7UN c* Were all items on the equiprnentmanufacturer's maintenance checklist completed? <br /> In the Section H,below,describe how and whex these deficiencies were or will be corrected. <br /> H. Comments: <br /> i <br /> r <br /> i <br /> i <br /> Page 3 of 3 03,01 <br />