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Aug-31-04 04:54pm From-Gettler-I*Inc +9166311317 0 T-357 P.004/009 F-269 <br /> aoitoriltg:Sysfem.CertiFicatium. <br /> Date o€'£estinglSmv'icutg: <br /> e-Address: <br /> ❑-Check this-box if tank gauging is used ont7F fo¢:irztncrmarp:cot»L <br /> In-TankGaugiitgfSlREquiptnent: ; CheckthisboxifnOtank:gaugittger'SIR'egwpinenr"S'instatled_. <br /> his section must.be cafaptetetl'if in-tank naaging,equip=at,is:used:no:perf&M1eaL&tectivrr.srtonitariagl <br /> om lete the followin .checklis{: �d.temtiitarion.including.testfngforground faults?' <br /> Q Yes Q No* Hasalfinputwiringbeemiospectedfurproperentry,- <br /> ❑ Yes ❑ No= Were all tank gaug ng:probes visually inspected for:damage..and residue buildup?•. <br /> ❑ Yes ❑ No* Was accuracy of system product level readings tested? <br /> ❑ Yes Cl No Was acm aay.of system:watec levet readings.tested?. <br /> Q Yes Q No Were all probesreinstalled properly? <br /> ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance ctiecklisteompleted? <br /> In the section li,below,describe how and when thesedeficieencies were or will be corrected. <br /> G ciCheck this box if LLDs are not installed. <br /> Line Leak Detectors (Ll A): <br /> mom Icte the fol lowin checklist: <br /> ❑ Yes ❑ No* For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance. <br /> ❑ N/A (Check all Char apply) Simulated leak rate: ❑ 3 g.p•h.; ❑0.1 g.p-h; ❑0.2 g-p.h. <br /> ❑ Yes O No* <br /> Werc all LLDs confirm d operational and accurate within regulatory requirements? <br /> ❑ Yes Q No* Was the testing apparatus properly calibrated? <br /> Q Yes ❑ No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> ❑ NIA <br /> O Yes ❑ No' For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak. <br /> ❑ NIA <br /> [I yes Q 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 /> ❑ Yes Q No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions !I <br /> Cl NIA or fails a test? <br /> ❑ Q No* For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> Yes <br /> ❑ NIA <br /> ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> * In the Section H, below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: - <br /> Page 3 of 3 osroo <br />