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,F.� -/A.Tarik Gauging/ SIR Equipment: • ❑ 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 />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. <br />Complete the following checklist: <br />® <br />Yes <br />❑ <br />No' <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />® <br />Yes <br />❑ <br />No' <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />® <br />Yes <br />❑ <br />No' <br />Was accuracy of system product level readings tested? 2 ,I <br />® <br />Yes <br />❑ <br />No' <br />Was accuracy of system water level readings tested? <br />® <br />Yes <br />❑ <br />No' <br />Were all probes reinstalled properly? Mq� <br />® <br />Yes <br />❑ <br />No' <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />... v.... �. v.• , .� , vcau„uc uu� auu �„C„ u,Cae YCY41 C,14,CD WC,C VI WIII UC {:VrfC4lVV. <br />Line Leak Detectors (LLD(: ❑ Check this box if LLDs are not installed. <br />® <br />Yes <br />❑ <br />No' <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) <br />❑ <br />N/A <br />Simulated leak rate: ® 3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />® <br />Yes <br />❑ <br />No' <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />® <br />Yes <br />❑ <br />No' <br />Was the testing apparatus property calibrated? <br />® <br />Yes <br />❑ <br />No' <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />❑ <br />N/A <br />❑ <br />Yes <br />❑ <br />No' <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />® <br />N/A <br />❑ <br />Yes <br />❑ <br />No' <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br />® <br />N/A <br />❑ <br />Yes <br />❑ <br />No' <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? <br />® <br />N/A <br />❑ <br />Yes <br />❑ <br />No' <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />® <br />N/A <br />® <br />Yes <br />❑ <br />No' <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />,,, oe4uvu , nu. anu..en mese oenmenmes were orwin oe corrected. <br />H. Comments: <br />87 120 18 22 3 <br />91 150 20 24 4 <br />DIE 145 17 20 3 <br />Monitoring System Certification Page 3 of 4 2/21/07 <br />