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?vlrnitoring System Certification <br />- F. In -Tank Gauging / SIR Equipment: 19 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 />Complete the fotiowzne checklist: <br />O Yes <br />Q <br />No* <br />Has all input wiring been inspected for proper entry and termination, including testing for o ound faults? <br />❑ Yes <br />❑ <br />No* <br />Were all tank gauging probes visually inspected for darnage and residue buildup? <br />0 Yes <br />❑ <br />No* <br />Was accuracy of system product level readings tested? j <br />0 Yes <br />❑ <br />No* <br />Was accuracy of system water level readings tested? <br />❑ Yes <br />❑ <br />No* <br />Were all probes reinstalled properly? <br />Yes <br />❑ <br />No* <br />Were all hems an the equipment manufacturer's :maintenance checklist completed? <br />in the Section rt, oetow, aescrine now and when these deficiencies were or will be corrected. <br />G. Line Leak Detectors (LLD) <br />Complete the following checklist: <br />❑ Check this box if LLDs are not installed. <br />9 Yes <br />U No* <br />For equipment start-up or annual equipment certification. was a leak simulated to verify LLD performance? <br />❑ N/A <br />(Check all that apply) Simulated leak rate: (0 3 g.p.h.. ❑ 0.1 g_p.h : ❑ 0.2 g.p.h_ i <br />�J Yes <br />❑ No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Yes <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />j )Q Yes <br />❑ No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? j <br />❑ N/A <br />j <br />❑ Yes <br />❑ No'" <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />V N/A <br />Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled f <br />C N/A <br />or disconnected? <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system maLrunctions <br />0 N/A <br />or fails a test? <br />Yes <br />❑ No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />49 Ni A <br />Yes <br />❑ Ivo* <br />Were all items on the equipment manufacturer's maintenance checklist completed? J <br />In the Section H, below. describe how and when these deficiencies were or will he corrected. <br />H. Comments: <br />UN -036 - 314 <br />Page 3 of <br />%"vw.unldocs. org <br />Rev. 36;04"01 <br />