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Work Order• 2275500 Monitoring System Certification - Page 3 of 3 Site Address: 10858 Trinity Pkwy Date of Testing/Servicing: 5114/10 F, In - Tank Gauging / SIR Equipment: 19 Check this box if tank gauging is used only for inventory control. ❑ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: ❑ Yes 1 ❑ No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? ❑ Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? ❑ 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 i ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? .11 O—LIVII n uviuw, drscrlbe now and when these oericiencies were or will be corrected. G. Line Leak Detectors (LLD): 0 Check this box if LLD's are not installed. Complete the followine checklist: • Yes ❑ No* For equipment start-up or annual equipment certification was a leak simulated to verify LLD performance? ❑ N/A (Check all that apply) Simulated leak reate: M 3 g.p.h. (1.); ❑ 0.1 g.p.h. (2.); ❑ 0.2 g.p.h. (2.). Notes: 1. Required for equipment start-up certification and annual certification. 2. Unless mandated b local agency, certification required only for electronic LLD start-up. • Yes ❑ No* Were all LLD's confirmed operational and accurate within regulatory requirements? CK Yes ❑ No* Was the testing apparatus properly calibrated? ❑ Yes ❑ No* For mechanical LLD's, does the LLD restrict product flow if it detects a leak? CL N/A C1 Yes ❑ No* For electronic LLD's, does the turbine automatically shut off if the LLD detects a leak? ❑ N/A 1 11 Yes ❑ No* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system is disabled ❑ N/A or disconnected? M Yes ❑ No* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system ❑ N/A malfunctions or fails a test? lE Yes ❑ No* For electronic LLD's, have all accessible wiring connections been visually inspected? ❑ N/A 11 tz Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? ul JCCUVn n Below, describe now and when tnese deliciencies were or will be corrected. H. Comments: Tanknology Inc. 11000N. MoPac Expressway, Suite 500, Austin, Texas 78759