Laserfiche WebLink
(,.fitoring System Certification <br /> Site Address: 16470 CAMBRIDGE Date of Testing/Service: 11/14/2008 <br /> F. In-Tank Gauging / SIR Equipment <br /> Check this box If tank gauging is used only for inventory control. <br /> ❑ Check this box if no tank gauging or SIR equipment is installed. <br /> 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 following checklist: <br /> ❑Yes ❑NO' Has all input wiring 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 ❑No' Was accuracy of system product level readings tested? <br /> El Yes ❑No' Was accuracy of system water level readings tested? <br /> vas ❑No' Were all probes reinstalled properly? <br /> ❑vee ON.-I Were all items on the equipment manufacturers'maintenance checklist completed? . <br /> In the Section H,below,describe how 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 following checklist: <br /> For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance? <br /> Q Yes ❑No• ❑NIA (Check ail that apply)Simulated leak rale: 0 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 properly calibrated? <br /> MY. [—]NO' ❑NIA For mechanical LLDs,does the LLD restrict product Flow If It detects a leak? <br /> Yes []NO• ®NIA For electronic LLDs,does the turbine automatically shut off If the LLD detects a leak? <br /> ❑ves ❑No• Q NIA For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br /> ❑Yes ❑No' Q N/A For electronic LLDs,does the turbine automatically shut off If any portion of the monitoring system malfunctions or fails a test? <br /> r❑1 Yes []No* X NIA For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> U Yes ❑No• Were all items on the equipment manufacturers'maintenance checklist completed? <br /> In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: <br /> Page 3 of 3 Based on CA form dated 03101 <br />