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In Section H, below, describe how and when these deficiencies were or will be corrected. Line Leak Detectors (Ii ❑ Check this box if LLDs are not installed ❑ F. In -Tank Gauging !SIR Equipment: El Check this box if tank gauging is used only for ro El Check this box if no tank gauging or SIR equipmveen FECEIVED No' For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. ❑ Complete the following checklist: ® Yes ❑ No" 015 ® Yes ❑ No' Has ail input wiring been inspected for proper entry and termination, including testing for ground faults? No` ® Yes ❑ No` Were all tank gauging probes visually inspected for damage and residue buildup?EENVIRONN'NTAL ❑ ® Yes ❑ No' Was accuracy of system product level readings tested? $ACIUT ® Yes ❑ No` Was accuracy of system water level readings tested? ❑ ❑ Yes ❑ No' Were all probes reinstalled properly? For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? 0 Yes ❑ No` Were all items on the equipment manufacturer's maintenance checklist completed? N/A In Section H, below, describe how and when these deficiencies were or will be corrected. Line Leak Detectors (Ii ❑ Check this box if LLDs are not installed ❑ Yes ❑ No' For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) ❑ NIA Simulated leak rate: E 3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0,2 g,p.h. ® Yes ❑ No" Were all LLDs confirmed operational and accurate within regulatory requirements? Yes ❑ No` Was the testing apparatus properly calibrated? Yes ❑ No" For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ❑ NIA ❑ Yes ❑ No` For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? N/A ❑ Yes ❑ No' For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? N/A ❑ Yes ❑ No" For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? ® N/A Cl Yes ❑ No' For electronic LLDs, have all accessible wiring connections been visually inspected? ® NIA ® Yes ❑ No" Were all items on the equipment manufacturer's maintenance checklist completed? ` In Section H, below, describe how and when these deficiencies were or will be correctea. H. Comments: Monitoring System Certification Page 3 of 4 2/21107