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From: Franzen-Hill Inc. To: 12094683433 Page:5/8 Date: 1/20/2014 4:36-148 PM <br /> M01kitpring system Certification <br /> F. In-Tank Gauging/SIR Equipment: 1Z Check this box if tank gauging is used only for inventory Control. <br /> 0 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 cheeldist: <br /> 0 Yes CE33Ha all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> 0 Yes 0 No* Were all tank ganging,probes visually inspected for damage and residue buildup? <br /> 0 Yes [I No* Was accuracy of system product level readings tested? <br /> 17-1 Yes E3 No* Was accuracy of system water level readings tested? <br /> 0 yes [3 No* Were all probes reinstalled properly? <br /> 0 Yes ❑ No* Were all items on the equipment manubaurer'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 LLDs are not installed. <br /> Conn latethe following checkfist: verify LLD performance? <br /> 0 Yes [5 No* For equipment start-up or annual equipment-outificatior, was a leak simulated to <br /> El N/A (Check all that apply) Simulated leak rate: 0 3 g.p.b.; 0 0.1 pp.h; 0 0.2 g.p.h. <br /> 0 Yes [I No* Were all LLDs confirmed aperatmal and accurate within regulatory requirements? <br /> 0 yes 0 No* Was the testing apparatus properly calibrated? <br /> 0 Yes 0 No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> 0 NIA <br /> 0 Yes 0 No* ; For clectronic LLDs,does the turbine automatically shut off if the ULD detects a leak? <br /> 0 N/A <br /> 0 Yes [I No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> M N/A or disconnected? <br /> 0 Yes 0 Ne For electronic LLDs, does the turbine automatically slant of if any portion of the monitoring system <br /> 0 N/A malfunctions or fails a test? <br /> JbIM <br /> In <br /> 0 Yes 0 No* For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> 0 N/A <br /> 0 Yes 0 No* 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 /> R. Comments: <br /> This fax was sent with GFI FAXmaker fax server. For more information,visit: http://www.gfi-com <br />