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L � F. In-Tank Gauging/SIR Equipment: ® Check this box g tank gauging is used only for lovel�4taiil+ti Ica- ❑ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. JUL 18 2016 Complete the following checklist: ❑ Yes ❑ No' Has all input wiring been inspected for proper entry and termination,including testing for ground faults? ❑ Yes ❑ No' Were all tank gauging probes visually inspected for damage and residue buildup? ❑ Yes ❑ No' Was accuracy of system product level readings tested? ❑ Yes ❑ No' Was accuracy of system water level readings tested? ❑ Yes ❑ No' Were all probes reinstalled properly? ❑ Yes ❑ No' Were all items on the equipment manufacturers maintenance checklist completed? In Section H,below,describe how and when these deficiencies were or will be corrected. Line Leak Detectors(LLD): ❑ Check this box if LLDs are not installed. Complete the following checklist: ® Yes ❑ No' For equipment start-up or annual equipment certffication, was a leak simulated to verify LLD performance? (Check all that apply) ❑ N/A Simulated leak rate: ®3 g.p.h.; ❑0.1 g.p.h; ❑0.2 g.p.h. ® Yes ❑ No' Were all LLDs confirmed operational and accurate within regulatory requirements? ® Yes ❑ No' Was the testing apparatus properly calibrated? ® Yes ❑ No' For mechanical LLDs,does the LLD restrict productgow if it detects a leak? ❑ N/A ❑ Yes ❑ No' Forelecbonic LLDs,does the turbine automatically shut off if the LLD detects a leak? ® N/A ❑ Yes ❑ No' For electronic LLDs,does the turbine automatically shut off If any portion of the monitoring system is disabled or disconnected? ® N/A ❑ Yes ❑ No' For electronic LLDs,does the turbine automatically shut off H any portion of the monitoring system malfunctions or fails a test? ® N/A ❑ Yes ❑ No' For electronic LLDs,have all accessible wiring connections been visually inspected? ® N/A ® Yes ❑ No' Were all items on the equipment manufacturer's maintenance checklist completed? In Section H,below,describe how and when these deficiencies were or will be corrected. H. Comments: Monitoring System Certification Page 3 of 4 2/21/07