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-Monitoring System Certification <br /> F. Ira-Tank Gauging/SIR Equipment: Check this box if tank gauging is used only for inventory control. <br /> Check this box ifno tank gauging or SJR equipment its installed. <br /> This section must be completed if in-tank ganging equipment is used to perform leak detection.Monitoring. <br /> Complete the following checklist.- <br /> E-1 <br /> hecklist:❑ Yes El No* Has all input wiring been inspected for proper entry and termination,incluft testing for wound 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 /> ❑ Yes ❑ NO Was accuracy of system water level readings tested? JUN 16 2015 <br /> ❑ Yes ❑ No* Were all probes reinstalled properly? <br /> 0 Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? ' <br /> *lin Section)El~,below,describe bow and wben these defeieneies were or will be corrected. <br /> G. Line Leak Detectors (LLD): ❑ Check this bozo if LLTUs are not installed. <br /> Corn Tete the followitax checklist: <br /> VYesYesCl No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br /> [IN/A (Check all that apply) Simulated leak rate: 3 g.p.h-; ❑0.1 g.p.h; El0.2 g.p.b. <br /> ❑ No* Were allLLDs confirmed operational and accurate within regulatory requirements? <br /> ❑ No* Was the testing apparatus properly calibrated? <br /> Yes ❑ No* For mechanical LLDs,does the LLD restrict product flow if it detect,%a ieak7 <br /> D N/A <br /> Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> ❑ NIA, <br /> 'Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> ❑ N/A or discomected7 <br /> Yes 0 No* For electronic LLD5,does the turbine automatically shut off if any portion of the monitoring system malfunctions <br /> ❑ N/A or fails a test? <br /> Yes ❑ NO For electronic LLDs,have all accessible wiring connectioms been visually inspected? <br /> ❑ N/A <br /> Yes ❑ No* Were all items on the equ4nnent manufacturer's maintenance checklist completed? <br /> *to Section ki,below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: 4G5 <br /> C�11 <br /> Page 3 of 4 <br /> UN-036-,5/6 www.unidm.org Kcv,01117/08 <br />