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RPR-30-200? 10:01 Service Station Systems 408 938 eeee P.05 <br /> Monitoring System Certification-1 3 of 3 <br /> Site Address: 0445 N. Paefie Ave.!I Central Ct. Date of Testing/Servicing: 4/9107 <br /> F. In-Tank Gauging/SIR Equipment: 0 Check this box if tank gauging is used only for inventory control. <br /> 0 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 /> ti Yes 0 No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br /> Q Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> •Yes 0 NO Was accuracy of system product level readings tested? <br /> CK Yes 0 No* Was accuracy of system water level readings tested? <br /> M Yes 0 No* Were all probes reinstalled properly? <br /> CK 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 /> G. Line Leak Detectors (LLD): ❑ Check this box if LLD's are not installed. <br /> Complete the following checklist: <br /> tit Yes 0 No* For equipment start-up or annual equipment certification was a leak simulated to verify LLD performance? <br /> 0 N/A (Check all that apply) Simulated leak reate:ix 3 g.p.h.(L); 0 0.1 g.p.h. (2); 0 0.2 g.p.h.(2.). <br /> Notes: 1. Required for equipment start-up certification and annual certification. <br /> 2. Unless mandated by local agency, certification required only for electronic LLD smrt- <br /> •Yes 0 No* Were all LLD's confirmed operational and accurate within regulatory requirements? <br /> •Yes 0 NO Was the testing apparatus pro erly calibrated? <br /> 0 Yes 0 No* For mechanical LLD's,does the LLD restrict product flow if it detects a leak? <br /> Q N/A <br /> cK Yes 0 No* For electronic LLD's,does the turbine automatically shut off if the LLD detects a leak? <br /> 0 N/A <br /> is Yes 0 No* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> 0 N/A or disconnected? <br /> B Yes ❑ No* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system <br /> 0 N/A malfunctions or fails a test? <br /> lz Yes 0 NO For electronic LLD's,have all accessible wiring connections been visually inspected? <br /> 0 N/A <br /> M Yes 1 0 No* I 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- Replaced syphon jets on both Regular turbines and Premium turbine <br />