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1. <br /> .1 • ® Check this box if tank gauging is*only for inventory control. <br /> F. In-Tank Gauging I SIR Equipment: ❑ Check this box if no tank gauging or SIR equipment is instElil9cli _s _ <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. <br /> Complete the following checklist: 2016 <br /> 01 r <br /> El Yes Yes ❑ No` Has all input wiring been inspected for proper entry and termination,including testing for ground faults? �U1 <br /> Cl Yes ❑ No' Were all tank gauging probes visually inspected for damage and residue ENTAL <br /> ❑ Yes ❑ Nd Was accuracy of system product level readings tested? <br /> ❑ Yes ❑ No' Was accuracy of system water level readings testetl? <br /> ❑ Yes ❑ No' Were all probes reinstalled property? <br /> [3 Yes [3 No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> r Section H,below,describe how and when these deficiencies were or will be corrected. <br /> ie Leak Detectors(LLD): ❑ Check this box if LLDs are not installed. <br /> Com late the followin checklist: <br /> ® Yes ❑ No' For equipment gstart-up or annual egWpme„ oe❑rtifid zt9 P,hwas a leak simulated to verify LLD pertormance? (Check all that apply) <br /> ❑ NIA Simulated leak rate: ®3 g.p.h.; ❑ 9-P ' <br /> ® Yes ❑ No` Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> ® Yes ❑ No' Was the testing apparatus property calibrated? <br /> ® alk? <br /> Yes ❑ No- For mechanical LLDs,does the LLD restrict product How if it detects a le <br /> ❑ N/A <br /> a leak? <br /> T-1Yes ❑ No' For electronic LLDs,does the turbine automatically shut off if the LLD detects <br /> ® N/A <br /> E] Yes ❑ No' For electronic LLDs,does the turbine automatically shut off if any potion of the monitoring system is disabled or disconne <br /> ® N/A <br /> ❑ Yes 11LL <br /> No For electronic Ds,does the turbine automefically shut off if any portion of the monitoring system malfunctions or fails a test <br /> ® NIA <br /> ❑ Yes ❑ No' For electronic LLOS,have all accessible wiring connections been visually inspected? <br /> ® NIA <br /> ® Yes ❑ No' Were all items on the equipment manufacturer's maintenance checklist cempleted? <br /> In section H,below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: <br /> 2/21/07 <br /> Monitoring System Certification <br /> Page 3 of 4 <br />