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Site Address: 6347:2430 JOE POMBO P ,TRACY,CA 95376 D Test4n4n a�ervica _ ^® ^ G- <br /> MW <br /> F. In­TankG /SIELEq4mzut �heck <br /> eck this box if gaugingis used only for inventory control. <br /> this box if no tank gauging or SIR aquipment is instelied. <br /> This section must be completed if in-tank gau&&equipment is used to perform leak detection monitoring. <br /> Complete the following clocklist <br /> Yes No* Has On input wiring been inspectedfor proper evitty and te ation,includingtestingforgroundfaults? <br /> ffYes No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> Yes Ho* Was accuracy of system product level readings tested? <br /> Yes No* I Was accuracy of system water level readings tested? <br /> Yes " No* Were all probes reinstalled propel? <br /> Yes No* Were allitemr,oaths equipment manufacturer'smaintenance checkist completed <br /> *In tke Secdox H,below,describe kow and when dme deMencies were or will be comcled. <br /> G. Line LeakDetectors ): Check this box ifLLDsare not installed. <br /> complete the fello clue <br /> es No* Fm equipment startup or annual aant c tification. was a leak simulated to verify LLD perfosmance? <br /> NIA (Check,�Il IW apply) Simulated leak rate: g p h l; 0.1 g p IL3; 0.2 g.p h.2 <br /> Notes: 1. Required for equipment startup certafication lad annual certification. <br /> 2. Unless mandated by local agency,certification required only for electrunic ILD up. <br /> as M No* Were ail LLDs confinned operational and accurate within regulatory requirements? <br /> as No* Was the to apparatus properly calibrated? <br /> YesP/A <br /> o* For mechanical s,does the LLD restrictproductflow ifitdetects aleew. <br /> MOTO$ No* For electronic LLDs,does the ' a automatically shut if the LLD detects a leak? <br /> NIA <br /> as No* Far electronic LLDs, does the a automatically shut off if any portion of the monitoring system is disabled <br /> NIA or disconnected? <br /> as No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoringsystem ctions <br /> NIA or fails a test? <br /> of No* For electronic LLDs,have all accessible connections been inspected? <br /> NIA <br /> as <br /> No* Were all items on the equ4ment ufacturer's maintenance checklist completed? <br /> * <br /> lathe Section H,bolow,denAADVIV how and wken these defieiencies vm or be corrwted. <br /> IL Comments: <br /> i <br /> i <br /> I <br /> 1 <br /> E <br /> Page 3 of 3 43MI <br />