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Facility #: EP 1-1194 Test Date: 12/15/94 Work Order No. %3312 Tank Area Dispenser Area Stage II Equipment Check fill type General inspection: Check system type Coaxial: [ ] S U N/P Problem System Balance system:[ X] Dual Point: [ X] Impact valves: [ X] [ j [ ] [ j Assist system:[ I Conventional: ( ] Hoses and nozzles: ( X] [ 1 [ I [ I Check hose type Type of assist R U M P D O Coaxial:[ X] Check tank type Tank # . Check how determined Number of hoses per product: [ ] [ 4 ] [ 21 [ 21 [ ] [ ] Dual:[ X] Steel: [ ] [ ] Store manager: [ X] Number of dispensers per product: [ j [ 21 [ 11 [ 11 [ ] [ ] S U N/P Problem System SW Fiberglass: [ ] [ ] Store tank chart: [ ] Meter Y N Face seats:[ X] [ ] [ J [ ] DW Fiberglass: [ X] [ ALL ] Technician: [ ] Calibration sticker present: [ X] [ j 07/26/94 Belows (Boot):[ X] [ I [ J [ ] QWbodic prot.: [ I [ 1 Tank diameter: [ ] Vertical check valves: [ I [ X] Date of last calibration: Belows (Springs):[ X] [ ] [ ] [ ] nknown: [ I [ ] Visual verification: [ ] Electronic monitors m light: Red: [ ] Green: [ j Product Lines Y N Amp reading: Steel: [ I Suction: [ 1 Electronic tank gauges present:[ ] [ X] NOM, if fib.V— uk is ptesum,. mike Fiberglass: [ Xj Pressure: [ X] Type: pWc vaircum mtm be cmducM& Y N DW Fiberglass: [ ] Operational:[ ] [ ] Strike plate: [ X] [ I Trench liner present: [ ] Electronic line monitors present:[ ] [ X] Note: If problem, list tank# & product Cathodic protection: [ ] Type: S U N/P Problem System(s) Unknown: [ j Operational:[ ] [ I Fill Cover: [ X] [ ] [ j [ I Leak Detector Interstitual monitors present Fill cap: [ Xj [ ] [ ] [ I S U N/P Tanks:[ X] Fill cap seal: ( X1 [ I [ I [ l Upon arrival: ( X] [ I [ I Lines:[ ] Drop tube: [ X] [ I [ ] [ ] Replacement history Operational:[ X] [ ] Drop tube shield: [ I [ I [ XI [ j System Type Serial number Other monitors present V/R Cover: [ X] [ I [ I [ ] [REG/UNL ] [ DLD ] [ 206855260 j Type: V/R Cap: [ XI [ I [ I [ I [SUP 11 XLP I [ 507901303 1 Operational:[ I [ I V/R Seal: [ X] [ ] [ j ( ] [PLS J[ DLD I [ 211899843 ] Monitoring Wells V/R Dry Brake: [ X] [ I [ I [ I [ 11 1 [ I S U N/P mp: [ X] [ 1 [ I [ I [ 11 1 ( ] Present:( Xj [ I [ I p cover. [ Xj [ ] [ j [ I [ 11 1 [ ] Caps locked:[ I [ I [ X1 Overfill: [ I [ I [ X] ( I Containment System Problems:[ X1 [ I [ I Overspill: [ X] [ ] [ ] [ ] Check one Type: Y N Drain mechanism: [ X] ( ] [ 1 [ ] Fill pipe spill containment: [ XI Waste Oil Monitors - Present: [ X] [ I Ball float: [ X] [ I [ I [ ] At both subpump & dispenser ends: [ ] Type: Ball float length: [ X] [ ] [ I [ I At subpump end only: [ j Operational[ X] [ j Swing joints (tank end) At dispenser end only: [ ] OR Water Separator - Present:[ XI [ ] Flex ( ] Pipe X] Unk. [ I No containment: ( ] Quati[ : 1 Legend: S -Satisfactory; U -Unsatisfactory; N/P-Not Present; Y -Yes; N -No; R -Regular, U -Unleaded; M-Midgrade; P -Premium; D -Diesel; O -Other Comments: Nae: est secum it to be wed to hot imms which aed immeaiam aueatim aW m items which Cama he cmccwd a the nme d" test was comAlow. LEAK ALERT ANNULAR MONITOR SYSTEM. REG/UNL TURBINE RUNNING ALL THE TIME WHEN DISP SHUT OFF. REPORTED TO MAINT.