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Monitoring System Certification-Page 3 of 3 JUN 12 2015 `ENVIRONMENTAL Site Address: 3505 Navy Dr. 17at"e offiesnnglSer43icing: 5/13/15 F. In -Tank Gauging/SIR Equipment: 0 Check this box if tank gauging is used only for inventory control. ❑ Check this box if no tank ganging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the folio ing checklist: 0 Yes ❑ No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? ❑ Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? 0 Yes 0 No* Was accuracy of system product level readings tested? 0 Yes ❑ No* Was accuracy of system water level readings tested? ❑ Yes ❑ No* Were all probes reinstalled property? ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? *In Section H below,describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors(LLD): 0 Check this box if LLD's are not installed. Com lete the folio in2 checklist: 0 Yes 0 No* For equipment start-up or annual equipment certification was a leak simulated to verify LLD performance? ❑ N/A (Check all that apply) Simulated leak rate: 0 3 g.p.h.(I.); 0 0.1 g.p.h.(2.); 0 0.2 g.p.h.(2.). Notes: 1. Required for equipment start-up certification rLd annual certification. 2. Unless mandated by local agency,certification required only for electronic LLD start-up. 0 Yes D No* Were all LLD's confirmed operational and accurate within regulatory requirements? ❑ Yes 0 No* Was the testing apparatus properly calibrated? 0 Yes 0 No* For mechanical LLD's,does the LLD restrict product flow if it detects a leak? ❑ N/A 0 Yes 0 No* For electronic LLD's,does the turbine automatically shut off if the I.LD detects a leak? 0 N/A ❑ Yes 0 No* For electronic LLD's,does the turbine automatically shut off if any portion of the monitoring system is disabled 0 N/A or disconnected? ❑ Yes 0 No* For electronic LLD's,does the turbine automatically shut off if any portion of the monitoring system 0 N/A malfunctions or fails a test? ❑ Yes ❑ No* For electronic LLD's,have all accessible wiring connections been visually inspected? 0 N/A ❑ Yes ❑ No* tWere all items on the equipment manufacturer's maintenance checklist completed? * In Section H below,describe how and when these deficiencies were or will be corrected. It. Comments: Tank is monitored by a Sensor.