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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 gauging equipment is used to perform leak detection monitoring. <br />Com lets the followin <br />Q Yes ❑ No` <br />checklist: <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />E Yes <br />No` <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />® Yes <br />❑ <br />No' <br />Was accuracy of system product level readings tested? <br />® Yes <br />❑ <br />No` <br />Was accuracy of system water level readings tested? <br />Yes <br />No' <br />No' <br />Were all probes reinstalled properly? <br />© Yes <br />E] <br />No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />will be corrected <br />In the Section H, below, descri how and when these demienc s wereor <br />G. Line Leak Detectors (LLD):Mechanical ❑ Check this box if LLDs are not installed. <br />Complete the <br />followin checklist: <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check allNIA <br />No' <br />that apply) Simulated leak rate: ® 3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h.No' <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />No` <br />Was the testing apparatus properly calibrated? <br />No' <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />N/ANo' <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />fEF <br />N/A No' <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or <br />N/A <br />disconnected? <br />No' <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or <br />N/A <br />fails a test? <br />No` <br />For electronic LLDs, have all accessible wiringconnections been visually inspected? <br />N/ANo' <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />` In the Section H, below, describe how and when these deficiencies were or will oe corrected. <br />H. Comments: <br />Tested all PLLD's and found all passed. 3.0 leak shut down. Verified audible, visual and shut down. <br />Monitoring System Certification Page 3 of 4 <br />12107 <br />2/2 1/07 <br />