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01/12/2015 13:47 5596881467 FRANZEN HILL PAGE 04 <br />Moni toring Slystem Certification <br />' .1 �9, , r— � <br />'iA <br />F. In-T� 0 <br />ank Gauging/ StR Equipment: 0 Chcck this box if tank gauging is is , meed only for inventory control, <br />0 Check this box if no tank gau <br />�g <br />This section must be completed if in -tank gauging equipment is used to perform leak detectionn!Onitoring. <br />Complete the following checklist. <br />10 Yes [3 No* Has all input wiring been <br />0 �Y <br />7H:F— in-9XCt0d for Proper entry and termination, inclaftg jesting for ground fouls? <br />r <br />No* <br />1:1 yes I -D No* all tonic gauging probes vi,-,uall inspec(ed for damage and residue buildup? <br />0 yes-- Q—No* _WassccMfty Of system prodUct level readings tested? <br />[I Yes <br />[3 No* <br />W" accuracy of systeon water level. readings tested? <br />0 ycq <br />0 0* <br />Were 211 probes reinstalled prolmly? <br />CI Yes <br />0 No" <br />Were all items on the equipment manufacturer's maintenance checkliSt,compicted? <br />In the <br />Scetionff,Rb <br />describe =o�v and when =th.,.drcje=n,le, wc,, <br />orwall ire carr _ <br />G. Line Leak Detectors (LLJD): U Check this box if LuN are not installed. <br />_g2mplete tile folio ins! checklist: <br />Yes <br />U No* <br />For equipment start-up or annual equipment ccrtificatiM was a leak —Sir,mdated—to verify LLQ performance? <br />— <br />0 N/A <br />(Check all that tzpply) Simul;4ed Icak rete, C9 3 &p.h.; El 0,1 &p.h ; [3 01 g_p,h. <br />0 yes <br />0 No* <br />Were all LLDs confirmed Ol?emliOnal and accurate with rc&mlatoty requirements? <br />0 yes <br />0 No* <br />Was the testing apparatus prop-e--rly calibrated? <br />0 Yc4 <br />[:] No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />0 N/A <br />Yes <br />0NO <br />For electronic �JLD& does the turbine auto m8ticallY shut off if the LLD detects a leak? <br />—ye.; <br />0 N/A <br />E <br />0 Na* I <br />For clectranic LLD% does the turbine al'tOnlaticallY Shut off if any pattiOn Of the monitoring SyAern is disabled <br />0 N/A I <br />or disconnected? <br />0 0 No* For electronic U -M. does the turbine automatically shut aft' if any pm <br />Ron of the <br />0 N/A MalfimetionsnrMsateg? mordtoring system <br />0 yes L3 No* For electronic UL)s, have 811 2CCCSStble wiring connections been visually inspected? <br />CT N/A <br />Werc all items on the equipment manufacturer's Maintenance checklist completed? <br />10 the cUOR H, helow, describe W and when the" deficiencies were or will he corrected. <br />