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im6FTTLFR-RYAN INC. GR Job# 1820- 0072 <br /> SWRCB,January 2006 <br /> F. In-Tank Gauging/SIR Equipment: 0 Check this box if tank gauging is used only for inventory control. <br /> ❑ 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 /> Yes ❑ o Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> 0 Yes ❑ No' Were all tank gauging probes visually inspected for damage and residue buildup? <br /> 0 Yes ❑ No' Was accuracy of system products level readings tested? <br /> Yes [3 No' Was accuracy of system water level readings tested? <br /> E] Yes ❑ No' Were all probes reinstalled properly? <br /> I EI Yes No' Were all items on the equipment manufacturer's maintenance checklist completed? <br /> In the SectionH, a ow, esc a ow and when these deficiencies were orwill be corrected. <br /> G. Line Leak Detectors(LLD): ❑ Check this box if LLDs are not installed. <br /> Complete the following checklist <br /> 0 Yes ❑ o or equipment start-up or annual equipment certification,was a leak simulated to verify performance?(check ail <br /> ❑ N/A that apply) Simulated leak rate: ❑i 3 g.p.h. [] 0.1 g.p.h. F] 0,2 g.p.h. <br /> Yes ❑ NO* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> Yes ❑ No' Was the testing apparatus properly calibrated? <br /> 0 Yes ❑ No' For Mechanical LLDs,does the LLD restnct product Flow if it detects a leak? <br /> ® N/A <br /> 0 Yes ❑ No' For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> ❑ N/A <br /> 2] Yes ❑ No' For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled or <br /> ❑ N/A Disconnected? <br /> ® Yes ❑ No' or electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions or <br /> N/A fails a test? <br /> 0 Yes ❑ No' I For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> ❑ N/A <br /> ® Yes I ❑ No' were all items on the equipment manufacturers maintenance checklist completed? <br /> In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> G. Comments: <br /> Monitoring System Certification Page 3 of 4 12/07 <br /> 3 <br />