COMPLIANCE INFO_1986-2005 - Laserfiche WebLink

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Monitoring System Certification Site Address: 15 j Z//v(yI ns. Date ofTesting/Servieing: F. In -Tank Gauging/ SIR Equipment: CR Check this box if tank gauging is used only for inventory controL . ❑ Check this box if no tank gauging or SIR equipment is ins=-lled- This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring_ Complete the following checklist: Yes' ❑ No* . Has all input wiring been inspected for proper entry and including testing for ground faults- ❑ Yes [133 ❑ No* Were all tank gauging probes visually inspected for damage and residue bur�dup? Yes ❑ No* Was accuracy of system product level readings tested? Yes ❑ No; Was accuracy of system water level readings tested? ❑ Yes ❑ No* Were all probes.reinstalled properly? - - .Yes - ❑ No* Were all items on the equipment man s maintenauce:checklist completed? In the Section K. below, describe howand when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): ❑ Chock this box if LLDs are not installed. Complete the following checklist:: O - Yes i ❑ Nd* For equipment start-up or annual: equipment certification, was a leak*simulated to verify LLD performznce? ' -❑. NIA (Checktrll that,apply) Simulated leak rate: ❑ 3-g phi; ❑ 0.1 g p h?; ❑ 02 g_p.h.Z . Notes. L Required for equipment start-up certification and annual certification. -2 - Unless mandated by local agency; ce tificationyoquired only for electronic LLD start-up, ❑ -Yes - Cl No*• Were all U.Ds confirmed operational and accurate within -regulatory requirements? ❑ Yes Ll - No* Was the testing apparatus properly calibrated? ❑ Yes ❑ No* Foc mechanical LLDs, does the LLD restdct product flow if it detects a leak? ❑ NIA ❑ . Yes ❑ No* Torelectronic LLDs, does the turbine automatically shut off if the LLD detects a icak? ❑ NIA ❑ Yes ' a No* For electronic LLDs, does the turbine automatically shut off if any portion of lite monitoring system is disable ❑ NIA or disconnected? ❑ Yes ❑ "No*. .For electronic LLDs, does the. turbine automatically shut off if any. -portion of . the -monitoring. sti•stem ❑ N/A malfunctions or fails a test? - ❑ Yes ❑ Nos For electronic LLDs, have all accessible wiring connections been visually inspected? ❑ NIA ❑ Yes, . ❑ No* -Were all items .on the equipment manufacturer's maintenance checklist completed? * In the Section H. below. describe how and when these deficiencies were or will be corrected. IL Comments: