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MONITORING SYSTEM CERTIFICATI - . <br /> CERTIFICATION/TEST DATE: August 07, 2018 AUG 10 NII, <br /> A7. FACILITY A2. OWNER <br /> Name Quik Stop Market#138 Name Quik Stop Markets, Inc.ENVIRONMENTAL <br /> n l=l�9T <br /> Address 1153 Lincoln Blvd.,Tracy,CA 95376 address 4567 Enterprise Street,�{ It,'FrA' <br /> Phone# 510-657-8500 Phone# 510-657-8500 <br /> Contact Roger Batra Contact Debbie Markovich <br /> F. IN-TANK GAUGING/SIR EQUIPMENT: ■ Check this box if tank gauging is used only for inventory control. <br /> ❑ Check this box if no tank gauging or SIR equipment is installed. <br /> This section must be completed if in-tank gaugung equipment is used to perform leak detection monitoring. <br /> Complete the following checklist: <br /> ❑ Yes ❑ No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> ❑ Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> ❑ Yes ❑ No* Was accuracy of system product level readings tested? <br /> ❑ Yes ❑ No* Was accuracy of system water level readings tested? <br /> ❑ Yes ❑ No* Were all probes reinstalled properly? <br /> ❑ Yes ❑ 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 /> G. LINE LEAK DETECTORS (LLD): ❑ Check this box if LLDs are not installed. <br /> Complete the following checklist: <br /> ■ Yes ❑ No* For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance? <br /> ❑ NIA (check all that apply) Simulated leak rate: ■ 3 g.p.h.; ❑ 0.1 g.p.h.; ❑ 0.2 g.p.h. <br /> ■ Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> ■ Yes ❑ No* Was the testing apparatus properly calibrated? <br /> ■ Yes ❑ No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> ❑ N/A <br /> ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> ■ NIA <br /> ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> ■ N/A or disconnected? <br /> ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions <br /> ■ N/A or fails a test? <br /> ❑ Yes ❑ No* For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> ■ N/A <br /> ■ Yes ❑ 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 /> ©2018 Walton Engineering,Inc. <br /> Page 3 of 3 <br />