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04/18/2002 17:34 4689715 SSS INC � PAGE 04 <br /> .Monitoring Systeln Certification -Page 3 of 3 <br /> Site Address: 1071 N. Main St.,. Louise <br /> Date of Testing/Servicing, 03/19/02 <br /> F. in-Tank Gauging 1 SIR Equipment: ® Check-this box if rank gauging is used only for inventory control. <br /> ❑ Check this box if nu talak g-9i'19 of SIR equipment is in5tailcd_ <br /> This secti.otl must be completed if in-tank gauging equipment is used to perform leak detection monitoring. <br /> Com lets the following checklist: <br /> ❑yes Q No* Has all input wiring g been inspected for proper entry and termination,including testing for ground faults? <br /> ❑yes ❑No* Were all tank gauging probes visually inspected for damage and residue buildup'? <br /> ❑Yes <br /> ❑No* Was accuracy of system product level readings tested? <br /> t2 Yes ❑No* Was accuracy of system water level readings tested? <br /> ❑Yes ❑ No* Were all probes reinstalled properly'? <br /> ❑yes ❑ No* Were all items on the equipment mmufacturcr's maintenance checklist completed? <br /> * <br /> In Section H below,describe how and when these deficiencies were or will be corrected. <br /> G. Line Leak Detectors (LLD): ❑ Clieck this box if LLD's are not installed. <br /> Corn lets the following checklist: <br /> C9 Yes ❑ No" For equipment start-up or annual equlpturnl cel Gifivatiuu was a leak simulated to verify LLD perform=ce'7 <br /> ❑ NIA (Cheek all that apply) Silnulated leak.reate: 01 3 g,p.h_ (i); [] 0.1 g.ia.h.(2.); ❑ 0.2 g.p.h. (2.). <br /> dotes: 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 /> Ig Yes ❑ No* Were all LLD's confirmed operational and accurate within regulatory requirements? <br /> z Yes ❑No* Was the testtug apparatus properly calibrated'? <br /> ❑Yes ❑No* For mechanical LLD's,does the LLD restrict product flow if it detects a leak? <br /> {�N/A <br /> Yes Q No* For electronic LLD's, does the turbine automatically shut off if the LLD detects a leak? <br /> ❑NIA <br /> PFEIN/A <br /> No* For electronic LLD's,does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> or disconnected? <br /> No* Fes elLc tonic LLD's,docs the turbi:nc automaatically shut off if any Martian ofthe monitoring system <br /> N/A malfunctions or fails a test'? <br /> a Yes ❑ No* For electronic LLD's,have all accessible wiring connections been visually inspected? <br /> ❑N/A <br /> i81 Ycs ❑ No* I 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. Cumrnenls: <br />