COMPLIANCE INFO_2003-2010 - Laserfiche WebLink

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E E Date of Testing/Servicing: I �i IIIIIIIIIIII I � I 1111111111111 11111111111 � � �! I ! 111 � 1111 11'r MM OF-vlM MT 4 11 1 1 111111 ComDfete the followine checklist: - In the Section H, below, describe how and when these deficiencies were or will be corrected. PUMI Comalite the following checklist Has all unma wiring been inspected for proper entry and termination, including testing for ground fmflts? Rt Were all tank gauging probes visually inspected for damage and residue buildup? WON (Check all that apply) Simulated leak rate: ULMISM! Was accuracy of system water level readings tested? Notes: 1. R&quired for equipment start-up certification and annual certification. 7VVer—e all items on the equipment inainifitcturer's maintenance checklist completed? - In the Section H, below, describe how and when these deficiencies were or will be corrected. PUMI Comalite the following checklist In the Section H, below, describe how and when these deficiencies were or wiH be correctedL H. Comments: Page 3 of 3 03/01 070r �Cqmlpm ammal equip -T-1 TM To111IFT, on, M-9MWIT 18 11 IFT7 MiTTMETTZ - 'p'.h.'; (Check all that apply) Simulated leak rate: Notes: 1. R&quired for equipment start-up certification and annual certification. 2. Unless mandated by local agency, certification required only for electronic LLD stm-up. Was the testing apparatus properly calibrated? For mechanical LlDs, does the LLD restrict product flow ff it detects a leak? 4 LLDs, does the turbine automatically shut off if the LLD detects a leak? 0717 M T M7J 'P-tT1MrUf-h:O Mollwutq; SySWAL iW 0"j'-nU1*L R:, disconnectI For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or &ds a test For electronic LLDs, have all accessible wiring connections been visually inspected? In the Section H, below, describe how and when these deficiencies were or wiH be correctedL H. Comments: Page 3 of 3 03/01