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Monitoring System Certification-Page 3 of 3 <br /> Site Address: 4219 Morada Ln. Date of Testi*Servicing: 7122!08 <br /> F. In-Tank Gauging 1 SIR Equipment: t7 Check this box if tank gauging is used only for inventory conA. <br /> a Check 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 followin checklist: <br /> M Yes a No* Has ail input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> M Yes 0 No- Were all tank gauging probes visually inspected for damage and residue buildup? <br /> Q Yes 0 No Was accuracy of system product level readings tested? <br /> Q Yes a No* Was accuracy of system water level readings tested? <br /> Q Yes O No* Were all probes reinstalled properly? <br /> Q Yes t7 No' I Were all items on the equipment manufactumes maintenance checklist completed? <br /> +In Section K below,describe how and when these deficiencies were or will be corrected. <br /> E G. Line Leak Detectors(LLD): ❑ Check this box if LLD's are not installed. <br /> Complete the follo Inp checklist: <br /> *Yes O No* For equipment start-up or annual equipment certification was a leak simulated to verify LLD performance? <br /> a NIA (Check all that apply) Simulated leak reate:Q 3 g p.h.(L); 13 0.1 g.pA.(2.); a 0.2 g.p.h.(2.). <br /> Notes. 1. Required for equipment start-up certification and annual certification. <br /> 2. Unless mandated by local en ,certification required only for electronic LLD start-up. <br /> a Yes a No" Were all LLD's confirmed operational and accurate within regulatory requirementV <br /> *Yes n No* Was the testing apparatus properlycalibrated? <br /> ©Yes 0 No* For mechanical LLD's,does the LLD restrict product flow if it detects a leak? <br /> M NIA <br /> Q Yes D No* For electronic LLD's,does the turbine automatically shut off if the LLD detects a leait`t <br /> a N/A <br /> M Yes a No* For electronic LLD's.does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> a NIA or disconnected? <br /> iY Yes 13 No* For electronic LLD's,does the turbine automatically shut off if any portion of the monitoring system <br /> a NIA m&Mmctivns a fails a test? <br /> Q Yes D No* For electronic LLD's,have all accessible wiring connections been visually inspected? <br /> O NIA <br /> Ot Yes I d No* I Were all iterns 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 /> EL Comments: <br /> 1 <br /> a <br /> a <br />