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0 0 <br />F. In -Tank Gauging / SIR Equipment: ® Check this box if tank gauging is used only for i e A�YI `I v / E� <br />❑ Check this box if no tank gauging or SIR equip en AY/ G <br />This section must be completed W in -tank gauging equipment is used to perform leak detection monitoring. JUN 18 2015 <br />Complete the following checklist: IY J <br />In Section H, below, aescnbe now ane wren mesa ueuu,eu.,o� ••=•o �• ••••• ••- <br />Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />win checklist: <br />No' <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) <br />Has all input wiring been inspected for proper entry and termination, including testing Tor ground Taunsr <br />N/A <br />Simulated leak rate: ®3 g.p.h.; ❑ 0.1 g.p.h [10.2 g.p.h. <br />Were all tank gauging probes visually inspected for tlamage and residue buildup? NFA! TN <br />No' <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Was accuracy of system product level readings tested? <br />FCOm <br />KYesol, <br />Was the testing apparatus properly calibrated? <br />Was accuracy of system water level readings tested? <br />No' <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />Were all probes reinstalled properly? <br />N/ANo' <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />In Section H, below, aescnbe now ane wren mesa ueuu,eu.,o� ••=•o �• ••••• ••- <br />Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />' In Section H, below, describe now ana wnen mesa ueocurru,ea ..ei. •.• .,_ ......__-__. <br />H. Comments: <br />Monitoring System Certification Page 3 of 4 2/21/07 <br />TAL <br />NIT <br />win checklist: <br />No' <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) <br />N/A <br />Simulated leak rate: ®3 g.p.h.; ❑ 0.1 g.p.h [10.2 g.p.h. <br />No' <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />FCOm <br />No' <br />Was the testing apparatus properly calibrated? <br />No' <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />N/ANo' <br />For electronic LLOs, tloes the turbine automatically shutoff if the LLD detects a leak? <br />❑ <br />Yes <br />❑ <br />N/A <br />No' <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br />El <br />Yes <br />® <br />El <br />N/A <br />No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a lest? <br />® <br />N/A <br />❑ <br />Yes <br />❑ <br />No' <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />® <br />N/A <br />® <br />Yes <br />❑ <br />No' <br />Were all items on the equipment manufacturers maintenance checklist completed? <br />' In Section H, below, describe now ana wnen mesa ueocurru,ea ..ei. •.• .,_ ......__-__. <br />H. Comments: <br />Monitoring System Certification Page 3 of 4 2/21/07 <br />TAL <br />NIT <br />