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• <br />Monitoring System Certification - Page 3 of 3 <br />RECEIVED <br />JUL 21 2011 <br />ENVIRONMENTAL HZEALTH <br />Site Address: 1409 S. Airport Way,tqFftMfiV$Trvicing: 6/22/17 <br />F. In - Tank Gauging / SIR Equipment: a Check this box if tank gauging is used only for inventory control. <br />0 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 following checklist: <br />0 Yes <br />0 No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />0 Yes <br />0 No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />0 Yes <br />0 No* <br />Was accuracy of system product level readings tested? <br />0 Yes <br />0 No* <br />Was accuracy of system water level readings tested? <br />0 Yes <br />0 No* <br />Were all probes reinstalled properly? <br />0 Yes <br />0 No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In Section H below, describe how and when these deficiencies were or will be corrected. <br />G. Line Leak Detectors (LLD): ❑ Check this box if LLD's are not installed. <br />Complete the following checklist: <br />0 Yes <br />0 No* <br />For equipment start-up or annual equipment certification was a leak simulated to verify LLD performance? <br />0 N/A <br />(Check all that apply) Simulated leak rate: a 3 g.p.h. (1.); 0 0.1 g.p.h. (2.); 0 0.2 g.p.h. (2.). <br />Notes: 1. Required for equipment start-up certification and annual certification. <br />2. Unless mandated by local agency, certification required only for electronic LLD start-up. <br />a Yes <br />0 No* <br />Were all LLD's confirmed operational and accurate within regulatory requirements? <br />N Yes <br />0 No* <br />Was the testing apparatus properly calibrated? <br />a Yes <br />0 No* <br />For mechanical LLD's, does the LLD restrict product flow if it detects a leak? <br />0 N/A <br />0 Yes <br />0 No* <br />For electronic LLD's, does the turbine automatically shut off if the LLD detects a leak? <br />a N/A <br />0 Yes <br />0 No* <br />For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />a N/A <br />or disconnected? <br />0 Yes <br />0 No* <br />For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system <br />a N/A <br />malfunctions or fails a test? <br />0 Yes <br />0 No* <br />For electronic LLD's, have all accessible wining connections been visually inspected? <br />a N/A <br />a Yes <br />0 No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In Section H below, describe how and when these deficiencies were or will be corrected. <br />H. Comments: <br />