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11 <br />Monitoring System Certification - Page 3 of 3 <br />Site Address: 401 W. Kettleman Ln. <br />F. In -"rank Gauging / SIR Equipment: <br />.REcEovEEil, <br />IMIUMI <br />ENVIRONMENTAL <br />Date of Teq'�in'JN-e'r'vj'cin"g-�!"TI97ir <br />as Check this box if tank gauging is used only for inventory control. <br />[I 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 />Camnlete the fnilawino rhP.rk1i,.tt! <br />0 Yes <br />1 0 No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />0 Yes <br />0 No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />D Yes <br />C1 No* <br />Was accuracy of system product level readings tested? <br />0 Yes <br />n No* <br />Was accuracy of system water level readings tested? <br />0 Yes <br />0 No* <br />Were all probes reinstalled properly? <br />M Yes <br />0 No* <br />I on the equipment manufacturer's maintenance checklist completed? <br />* In Section H below, describe how and when these deficiencies were or will be corrected. <br />G. Line Leak Detectors (LLD): 0 Check this box if LLD's are not installed, <br />Cnmnletp the fislinwinu APPLAkt- <br />N Yes <br />0 No* <br />For equipment start-up or annual equipment certification was a leak simulated to verify LLD performance? <br />0 N/A <br />(Check all that apply) Simulated leak rate: a 3 &p.h. (1); 0 0.1 gp.h, (2.); 0 0,2 g.p.h, (2.). <br />Notes: 1. Required for equipment start-up certification and annual certification. <br />2. Unless mandated by local alent X, certification required onIX for electronic LLD start-up. <br />X Yes <br />0 No* <br />Were all LLD's confirmed operational and accurate within regulatoix requirements? <br />M Yes <br />0 No* <br />Was the testing apparatus properly calibrated? <br />Do Yes <br />0 No* <br />For mechanical LLD's, does the LLD restrict product flow if it detects a leak? <br />o N/A <br />0 Yes <br />El No* <br />For electronic LLD's, does the turbine automatically shut off if the LLD detects a leak? <br />as N/A <br />0 Yes <br />0 No* <br />For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />0 N/A <br />or disconnected? <br />0 Yes <br />El No* <br />For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system <br />Im N/A <br />malfunctions or fails a test? <br />0 Yes <br />[I No* <br />For electronic LLD's, have all accessible wiring connections been visually inspected? <br />0 N/A <br />iia Yes <br />❑ <br />items on the equipment manufacturer's maintenance checklist completed? <br />* In Section H below, describe how and when these deficiencies were or will be corrected. <br />1-1. Comments: <br />