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04/23/2004 20:13 408971 35 SSS INC PAGE 85 . Monitoring System Certification- Page 3 of 3 Site Address: 2575 Country Club Blvd. a..Plymouth _. Date of Testing/Servicing: 3124104 F. in -"rank Gauging/ SIR Equipment: 0 Check this box if tank gagging is used only for inventory control. ❑ Check this box if no tank gauging or SIR equipment is installed. Thi; section niust be completed if its-tfinlc gauging equipment is used to per['®.rm leak detection monitoring. Com Mete the follouling checklist: d Yes 11NO Has all input wiring been inspected for proper entry and termination, including testing for,round faults? ❑Yes Q NO Werc all tank gauging probes visually inspected for damage and.residue buildup? ®Yes ❑ No* Was accuracy of"system product level readings tested? ❑Yrs ❑ No* Was accuracy of systell,water level readings tested'? ❑Yes 1 ❑ No"' Werc all probes reinstalled properly'? ❑Yes ❑ No* Were all items on the equipment tnanu.facturer's maintenance checklist completed? ` *in Section R below,describe how and when these deficiencies were or will be corrected. G. Line:Lealc Detectors (I.LD)- ❑ Check this box if LLD's are not installed. Complete the'I'olioovin checklist: s Yes ❑ Noy` For equipment start-up or annual equipment certification was a leak simutatcd to verify LLD performance"? ❑ N/A (Cheek all that apply) Simulated leak reale: 3 3 g.p.h.(1); ❑ 0.1 g.p_h.(2.); ❑ 0.2 g.p.h.(2.). Notes_ 1. itcquircd.Cor equipment start-up eertifiesltion and annnstl nerrifieation. 2. Unless mandated by local age ne ,certification required only for electronic LLD start-up. 9 Yrs ❑ No" Wereall LLD's confirmed operational And accurate within regulatorX requirements? M Yes ❑ No* Was the testing apparatus properly calibrated'? ❑Yes ❑ NO For meclia.n:ieal LLD's,does the LLD restrict product flow if it detects a leak? ® N/A 9 Yes ❑ No* For electronic LLD's,does the turbine automatically shut off if the LLD detects a leak? ©Nl.AL ®Ycs ❑ No* For electronic LLD's,does the turbine automatically shut off if any portion of the nnonitoring system is disabled ❑ N/A or disconnected? ®Yes ❑ No" For elceironie LLD's,docs the turbine automatically shut off it*any portion of the monitoring system p N/A rualfunctions or fails a test? 3 Vcs ❑ No's For ele,=osuc LLD's,have all accessible wiring con.nectirtm,heer visnally inspected? ❑ N/A ®Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In Section.14 below,describe !tow And when these deficiencies were or will be corrected. IL Comments: