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jj �� //LIVED <br /> F. In-Tank Gauging/SIR Equipment: X Check this box if tank gauging is used onlfdt ntEfy 1.' <br /> 11 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. EEC 3 12015 <br /> Compleft the followi checklist: KIRAP1 <br /> ❑ Yes ❑ No' Has all input wiring been inspected for proper entry and termination,including testing for ground n;:P4RTMFN TL <br /> ❑ Yes ❑ No' Were all tank gauging probes visually inspected for damage and residue buildup? <br /> C Yes ❑ No' Was accuracy of system product level readings tested? <br /> ❑ 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 manufacturer's maintenance checklist completed? <br /> 'In the Section H,below,describe In and when these deficiencies were or will be corrected. <br /> G. Line Leak Detectors(LLD): , Check this box if LLDs are not installed. <br /> Complete the followingchecklist: <br /> X Yes ❑ No* For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance?(Check all <br /> ❑ WA that apply) Simulated leak rate: x 3 g.p.h.; ❑0.1 g.p.h; ❑0.2 g.p.h. <br /> X Yes ❑ No' Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> X Yes ❑ No- Was the testing apparatus property calibrated? <br /> ❑ Yes ❑ No' For mechanical LLDS,does the LLD restrict product flow if it detects a leak? <br /> X N/A <br /> x Yes ❑ No' For electronic LLDs,does the turbine automatically shut off rf the LLD detects a leak? <br /> WA <br /> x Yes ❑ No' For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or <br /> WA disconnected? <br /> x Yes ❑ No' For electronic LLDs,does the turbine automatically shut off'rf any portion of the monkoring system malfunctions or fails <br /> N/A a test? <br /> X Yes ❑ No' For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> CN/A <br /> X Yes No' Were all hems on the equipment manufacturer's maintenance checklist completed? <br /> •In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: <br /> Monitoring System Certification Page 3 of 4 12107 <br /> 3 2/21/07 <br />