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Monitoring System Certification - Page 3 of 3 FEB 2 7 2015 <br />Site Address: 3725 N. Tracy Blvd.ENVIB - Ing: 1/29/16 <br />p. <br />fqp_,py ON,14OX, <br />F. In - Tank Gauging / SIR Equipment: <br />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 />Comialete the following checklist: <br />❑ Yes <br />0 No* <br />Has all input wiring been inspected for proper entry and termination, including -felting for ground faults? <br />Ej Yes <br />0 No* <br />Were all tank gauging probes visually inspected for damage and residue*ildup? <br />0 Yes <br />0 No* <br />Was accuracy of system product level readings tested? <br />0 Yes <br />0 No* <br />Was accuracy of system water level readings tested? <br />0 Yes <br />0 No* <br />Were all probes reinstalled properly? <br />0- Yes <br />0 No- <br />Were all items on the equipment manufacturer's maintante checklist completed? <br />In Section If below, describe how and when these deficiencies wer or will be corrected. <br />'er ' <br />G. Line Leak Detectors (LLD): 77�hec',,k this box if LLD's are not installed. <br />Complete the following checklist: <br />0 Yes <br />0 No* <br />For equipment start-up or annual uipment certification was a leak simulated to verify LLD performance? <br />" annual <br />0 N/A <br />(Check all that apply) Simula d leak rate: 0 3 g.p.b. (l.); 0 0.1 g.p.h. (2.); 0 0.2 g.p.h. (2). <br />1, <br />Notes: 1. Required for ipment start-up certification and annual certification. <br />/atedby <br />local agency, certification required only for electronic LLD start-up. <br />2. Unless ma y local <br />0 Yes <br />0 No* <br />Were all LLD's confimied operational and accurate within regulatoa requirements? <br />0 Yes <br />D No* <br />Was the testing a aratus 2roperly calibrated? <br />0 Yes <br />D No* <br />For mechanicLD's, does the LLD restrict product flow if it detects a leak? <br />0 N/A <br />13 Yes <br />0 No* <br />For elecnic LLD's, does the turbine automatically shut off if the LLD detects a leak? <br />0 N/A <br />0 Yes <br />0 No* <br />Foelectronic LLD's, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />0 N/A <br />pf disconnected? <br />0 Yes <br />0 No* <br />For electronic LLD's, does the turbine automatically shutoff if any portion of the monitoring system <br />0 N <br />malfunctions or fails a test? <br />0 Yes <br />O/No* <br />For electronic LLD's, have all accessible wiring connections been visually inspected? <br />a N/A <br />0 Yes <br />0 No* <br />Were all 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 />H. Comments: TL AI's & LLD's are monitored by Veeder Root. <br />