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Monitoring System Certification • <br /> Site Address: 4943 S.KINGSLEY(FRONTAGE RD) Date of Tesfing/Service: 06/21/2010 <br /> HWY 99 @ ARCH AIRPORT RD <br /> F. In-Tank Gauging /SIR Equipment <br /> Check this box if tank gauging is used only for inventory control. <br /> ❑ C <br /> Check this box if no tank gauging or SIR equipment is installed. heck 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 /> QYes ❑No' Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> ❑X Yes ❑No' Were all tank gauging probes visually inspected for damage and residue buildup? <br /> QYes ❑No• Was accuracy of system product level readings tested? <br /> QYes ❑No• Was accuracy of system water level readings tested? <br /> X Yes No• Were all probes reinstalled properly? <br /> ElYes ❑No' Were all items on the equipment manufacturers'maintenance checklist completed? <br /> 'In the Section H,below,describe how and when these deficiencies were or vdll be corrected. <br /> G. Line Leak Detectors (LLD) : ❑ Check this box if LLDs are not installed. <br /> Complete the following checklist: <br /> ❑ ❑ ❑ For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance? <br /> Yes No• N/A (Check all that apply)Simulated leak rate: X 3 h 0.1 h 0.2 h <br /> ❑ 9•P� ❑ 9�P� ❑ 9�P� <br /> X Yes ❑No' Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> X Yes ❑No• Was the testing apparatus properly calibrated? <br /> Yes ❑No• Q N/A For mechanical LLDs,does the LLD restrict product Flow if it detects a leak? <br /> ❑X Yes ❑No• ❑NIA For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> ❑X Yes ❑No' ❑N/A For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br /> ❑X Yes ❑No• ❑N/A For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? <br /> 0 Yes ❑No• ❑N/A For electronic LLDs,have all accessible wiring connectors been visually inspected? <br /> M Yes ❑No• Were all items on the equipment manufacturers'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 Based on CA form dated 03/08 <br />