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MAR-18-2009 11:13 Service Station Systems 408 938 8888 P.05 <br /> Monitoring System Certification-P3*of 3 <br /> Site Address: 401 W.Kettleman Ln.a Hutchins ^ Date of Testing/Servicing: 2/24/09 <br /> F. In-Tank Gauging/SIR Equipment: M Check this box if tank gauging is used only for inventory control. <br /> ❑ Check this box if no tank gauging or SLR equipment is installed. <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. <br /> Com lets the following checklist: <br /> F, j <br /> 0 No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> 0 No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> R No* Was accuracy of system product level readings tested? <br /> ® No* Was accuracy of system water level readings tested? <br /> 0 No* Were all probes reinstalled properly? <br /> 13 Yes ❑ No* Were all items on the equipment manufaeturces mainteniince checklist completed? <br /> *In Section H below,describe how and when these deficiencies were or will be corrected. <br /> G. Line Leak Detectors(LLD): ® Check this box if LLD's are not installed. <br /> Comptete the foltowing checklist: <br /> •Yes ® No* For equipment start-up or annual equipment certification was a leak simulated to verify LLD performance? <br /> [l N/A (Check all that apply) Simulated leak reate:M 3 g.p.h.(L); a 0.1 g.p.h.(2.); 0 0.2 g.p.h.(2.). <br /> Notes: 1. Required for equipment startup certification and annual certification. <br /> 2. Unless mandated by local agency,certification r aired only for electronic LLD start-up. <br /> •Yes 13 No* Were all LLD's confirmed o erational and accurate within regulatory requirements? <br /> 4[Yes a Nog Was the testing a aratusro 1 calibrated? <br /> IN Yes 0 Nog For mechanical LLD's,does the LLD restrict product flow if it detects a leak? <br /> a N/A <br /> a Yes O No* For electronic LLD's,does the turbine automatically shut off if the LLD detects a teak? <br /> M N/A <br /> Cl Yes 0 No* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> M N/A or disconnected? <br /> ® Yes O No* For electronic LLD's,does the turbine automatically shut off if any portion of the monitoring system <br /> M N/A malfimctions or fails a test? <br /> ❑ Yes ❑ No* For electronic LLD's,have all accessible wiring connections been visually inspected? <br /> M N/A <br /> M Yes 13 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 /> H. Comments: <br />