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JUL-03-2002 14:29 qOUTHLAND CORP NW DIV. 503 9?? ??11 P. 12i19 <br /> Monit,,-Ing System Certification <br /> Site Address: 1399 N. MAIN ST. Date of Testing/Service! 06/11/2002 <br /> NORTH GATE <br /> F. In-Tank Gauging/SIR Equipment ❑ Chock this box if tank gauging is used only for inventory control. <br /> ❑ Chock 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 /> ❑Yee ❑No• Has all Input wiring been inspected for propor 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 /> ❑Yea FIN.• Was accuracy of system water level readings tested? <br /> Yee ❑No• Were all probes reinstalled proporly? <br /> ❑res ❑No' Were ail items on the equipment manufacturers'maintenance checklist comploted7 <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 checkllat: <br /> For equipment start-up or annual oquipment certification,was a leak simulated to verify LLD performance? <br /> Q Yes ❑No' N/A (Chock all that apply)Simulated leak rate! Q 3 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 /> 0 Yea ❑No• ❑NIA For mechanical LLDs,does the LLD restrict product flow If it detects a leak? <br /> ❑Yes ❑No' ❑X NIA For electronic LLDs.does the turbine automatically shut off if the LLD detects a leak? <br /> ❑Yes []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 ❑No0 NIA For olectronlc LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a lest? <br /> ❑Yes []No' ❑x MA For electronic LLDs,have all accessiblo wiring connections been visually inspected? <br /> ❑Yes ❑No• Wore all items on the equipmonl manufacturers'maintenance checklist completed? <br /> 'In the Section H,below,describe how and when thoso deficiencies were or will be corroctod. <br /> H. Comments: <br /> page 3 of 3 <br />