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03703/2011 11:23 5596881467 FRANZEN HILL PAGE 04 <br />0 10 <br />Monitoring Systene C*MftsNon Page 2 of a <br />7i/0T <br />F, In -Tank Gauging P SIR Equipment: F. check this box if tank gauging is used only fot^ Inventory Control. <br />.F, Gheck this box if no tank gauging or SIR equipment Is installed. <br />This section must be completed If "nk gauging equipment is used to perform leak detection monitoring. <br />E <br />Yes <br />E <br />No' <br />Has all input wiring been inspected for proper entry and twrnittation. Including testing for ground faults? <br />E <br />Yes <br />E <br />No" <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />E <br />Yes <br />E <br />No" <br />Was accuracy of system product level readings tested? <br />E <br />Yes <br />E <br />No* <br />Was accuracy of system water level readings tested? <br />E <br />Yes <br />E <br />No' <br />Were as probes reinstalled property? <br />E <br />Yes <br />E <br />No' <br />Were ON items on the equipment manufacturer's maintenance checklist completed? <br />* <br />In the Section <br />W, below, describe how and when these defrciencies were or will be correded. <br />G. lane Leak Detectors (LLD): E Check this box if LLDs are not installed <br />ConVete the followlnq checklist:- <br />X. <br />hecklist: <br />X. Yes No* For equlpmetlt start-up or annual equipment certification, was a leak simulated to verify LLD performarKM? (Check aft <br />NIA fhatappfy) Simulated leak rate: is 3 g.p.h.; F 0.1 g.p.h ; F. 0.2 g.p.h. <br />X Yes No" Were all LLDs corAmed operational and accurate within regulatory requirements? <br />X Yes No" Was the testing apparatus properly calibrated? <br />�. Cb Iyu- r ar nteonantcar LLus, 0082 the LLD restrict product flow If it detects a leak? - <br />NIA <br />Yes No" For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />X NIA <br />Yes No' For electronic LLDs, does the turbine automaticagy shut off if any portion of tate monitorings Is disabled <br />X NIA or <br />Yes No* For electronic LLDs, does the turbine automatically shut off If any portion of the monitoring system malfunctions or <br />X NIA falls a test? <br />Yes No' For electronic LLDs, have all accessible wiring connections beers visually Inspected? <br />X NIA <br />X Yes No* Were all items on the equipment manufacturer's maintenance checklist completed? <br />" to the section H, below, describe how and when these deficiencies were or will be corrected. <br />W. Comments: <br />Monitming System CettibrAti o7 Px" 3 of 4 <br />12107 <br />