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F. In-Tank Gauging I SIR Equipment: 0 <br /> ® Check this box if tank gauging is used only for inventory control. <br /> ❑ Check this box if no tank gauging or SIR equipmentt Ii letl ® ri <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. ~`+ Iry L <br /> Complete the following checklist: <br /> ❑ Yes ❑ No- Has all input wiring been inspected for proper entry and termination,including testing for ground faults? j D <br /> ❑ Yes ❑ No* Were all tank gauging probes visually Inspected for damage and residue buildup? <br /> ❑ Yesr�i <br /> ❑ No' Was accuracy of system protluct level reatlings tested? I V <br /> ❑ YesI-ICQt <br /> ❑ No' Was accuracy of system water level readings tested? TU 111=011 TRAGI-- <br /> ❑ Yes ❑ No' Were all probes reinstalled property? <br /> ❑ Yes ❑ No' Were all items on the equipment manufacturers maintenance checklist completed? <br /> In Section H,below,tlescribe how antl when these tleficiencles were or will be correctetl. <br /> Line Leak Detectors(LLD): ❑ Check this box if LLDs are not installed. <br /> Com mete the followin checklist: <br /> ® Yes ❑ No' For equipment start-up or annual equipment certification, was a leak simulated to verifyLLD Performance? (Check al/that apply) <br /> /❑ NIA Simulated leak rate: ®3 g.p.h.; ❑0.1 g.p.h El 0.2 gp.h. <br /> ® Yes ❑ No' Were all LLDs confirmed operational antl accurate within regulatory requirements? <br /> ® Yes ❑ No' Was the testing apparatus property calibrated? <br /> ® Yes ❑ No` For mechanical LLDs,tloes the LLD restrict protluct flow if it detects a leak? <br /> ❑ N/A <br /> ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut otf if the LLD tletects a leak? <br /> ® NIA <br /> ❑ Yes ❑ No' For electronic LLDs,does the turbine automadcall shut off if an <br /> ® N/A Y Y Portion of the monitoring system is disabletl or disconnectetl? <br /> ❑ <br /> as ❑ No' For electronic LLDs,does the turbine automallcall shutoff i(an <br /> ® NIA Y y portlon of the monhoring system malfunctions or fails a test? <br /> ❑ Yes ❑ No- For electronic LLDs,have all accessl6le wiring connections been visually inspected? <br /> ® NIA <br /> ® Yes ❑ No' Were all items on the equipment manufacturefs maintenance checklist compleled7 <br /> 'In Section H,below,describe how antl when these tleficiencles were or will be comectetl. <br /> H. Comments: <br /> Monitoring System Certification Page 3 of 4 <br /> 2/21/07 <br />