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F. In-Tank Gauging/SIR Equipment: ® Check this box if tank gauging is used only forn <br /> ❑ Check this box if no tank gauging or SIR equrini _ I 411e f <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring, <br /> �; <br /> Complete the following checklist: <br /> ApR 19 20 <br /> [[:M::7` Has all input wiring been inspected for proper entry and lamination,including testing for ground faults? <br /> Were all tank gauging probes visually inspected for damage and residue buildup? <br /> Ni Was accuracy of system product level readings tested? ....0 <br /> Was accuracy of system water level readings tested? <br /> Were all probes reinstalled property?Were all items on the equipment manufacturers maintenance checklist completed? <br /> •In Section H,below,describe how and when these deficiencies were or will be corrected. <br /> Line Leak Detectors(LLD): ❑ Check this box if LLDs are not installed. <br /> Com lots the followin checklist: <br /> ® Yes ❑ No' For equipment start-up or annual equipment certification, was a leak simulated to verifyLLD MIChckll That apply) <br /> ❑ N/A Simulated leak rate: ®3 g.p.h.; ❑0.1 g.p.h ❑02 g.p.h. ppp Y) <br /> ® Yes ❑ No` Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> ® Yes ❑ No' Was the testing apparatus properly calibrated? <br /> ® Yes ❑ Ni For mechanical LLDs,does the LLD restrict product flow If it detects a leak? <br /> ❑ N/A <br /> ❑ Yes ❑ No' For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> ® N/A <br /> ❑ Yes ❑ No' For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is ted?N/A <br /> ❑ Yes ❑ No` For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system mst? <br /> ® N/A <br /> ❑ Yes ❑ No' For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> ® N/A <br /> ® Yes ❑ No` Were all items 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 /> H. Comments: <br /> Monitoring System Certification Page 3 of 4 2/21/07 <br />