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12/14/2015 16:35 2658337676 <br />A ONE GAS PAGE 04/06 <br />DEC 14 20i` <br />M oitoriog System Certification EN4!!R0N.M..ENT.A.I <br />Ur_Q1'ru MCOn1 'r�ACA0..;. <br />F. In -Tank Gauging / SIR Equipment: De Check this box if tank gauging is used only for imentory 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 monitunrig. <br />Complete the following checklist: <br />❑ Yes <br />© No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />❑ Yes <br />❑ No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />❑ Yes <br />❑ No* <br />Was accuracy of system product Ievel readings tested? <br />❑ Yes <br />❑ No* <br />Was accuracy of system, water level readings tested? <br />❑ Yes <br />❑ No* <br />Were all probes reinstalled properly? <br />❑ Yes <br />❑ NO <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />'A In Section H, below, describe how and when these deficiencies were or will be corrected. <br />G. Line Teak. Detectors (LLD): ❑ Check flus box if LLDs are not installed. <br />Complete <br />the follo ing checkllst: <br />Yes M No* I For equipment start-up or annual equipment certification, was a leak. simulated to verify LLD perforruance? <br />ElNIA I (Check all that apply) Simulated❑ leak rate: V 3 g.p.h.; 0.l g.p.h ; ❑ 0.2 g.p.h. <br />Yes ❑ No* Were stl LLUs confirmed operational and accurate within regulatory requirements? <br />�1 Yes ❑ No* . Was the testing apparatus properly calibrated? <br />Yes ❑ No]E] mechanicaldoes the, LLD restrict product flow if it detects a leak? <br />C7 N/ <br />❑ Yes ❑ Noes the turbine automatically shut off if the LLD detects a leak? <br />N/ <br />0 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 />0 Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malf notions <br />N/A or fails a test? <br />C1 Yes Cl No* For electronic LLDs, have all accessible wiring cottttections bec`n visually ins $c <br />� N/A <br />JQ Yes 0 No* Were all items on the equipment manufacturer's maintenance checklist completed? <br />w In Section 11, below, describe how and when these deficiencies were or will be corrected. <br />;fll. Comments: <br />UN -036 — 516 <br />Page 3 of 4 <br />prww.kjaidoMOq <br />Rev. 01117/0$ <br />