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Monitoring System Certification <br /> Check this box if tank gauging is used only for inventory control. <br /> F. Tn-Tank Gouging/SIR Equipment: ❑ Check this box if no tank gauging or SXR equipment is installed. <br /> Thus 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 ir{put wiring been inspected for proper entry and tcrminafion,including testa g for ground faults? <br /> jo Yes ❑ No* Were all tank gaugivag probes visually inspected for damage and residue buildup? <br /> J4 yrs ❑ No* Was accuracy of system product level readings tested? <br /> W Yes ❑ Na* Was accuracy of system water level readings tested? <br /> Yes 0 No* Were an probes reinstalled properly? <br /> �j Yes ❑ No* Were all items ori the equipment manufacturer's maintenance checklist completed? <br /> *In Section H,below,describe how and when these.deficiencies were or will 6e corrected. <br /> G. Line Leak Detectors (I.LD): ❑ Check this box if LLDs are not installed. ' <br /> phe foilowin checklist: <br /> ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br /> ❑ NIA (Check all that apply') Simulated leak rate: A 3 g.p.h.; O 0.1 g.p.h; I]p.2 g.p.h. <br /> ] No* Were all LLDs cotTrmed operational.and.accurate within regulatory requirements? <br /> ❑ No* Was the testing apparat�xs properly calibrated? <br /> } Yes [I No's For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> ❑ N/A <br /> ❑ Yes ❑ No* For electrooic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> NA <br /> ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut of if any portion.of th.,monitoring systema is disabled <br /> Vj N/A or disconnected? <br /> Yes ❑ No* For electronic LLDs,does the turbine automatically shut off.if any portion of the monitoring system malfunctions <br /> lq N/A or fails a test? <br /> ❑ Yes L] No* For electronic LLDs,have A accessible wiring co viections been visually inspected? <br /> 9( N/A <br /> Yes ❑ No* Were ail items on the equipment manufacturer's maintenance checklist completed? <br /> *In section U,below,describe how and when these deficiencies were or will be corrected. <br /> 1 <br /> 14. Comments: — <br /> Page 3 of 4 <br /> UN-036—516 www.unidoct.org Rev.OV17108 <br />