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Monitoring System Certification <br /> F. In-Tank Gauging/SIR Equipment: 0 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 checklist: <br /> 0 Yes 0 No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> • Yes 0 No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> • Yes 0 No* Was accuracy of system product level readings tested? <br /> • Yes 0 No* Was accuracy of system water level readings tested? <br /> • Yes 0 No* Were all probes reinstalled properly? <br /> Z Yes 1 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 /> G. Line Leak Detectors(LLD): 0 Check this box if LLDs are not installed. <br /> Complete the follollin K5,checklist: <br /> I _�O No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br /> Yes 0* <br /> 0 E❑ <br /> 3 NIA (Check all that apply) Simulated leak rate: 0 3 g.p.h.; 0 0.1 g.p.h; 0 0.2 g.p.h. <br /> 0 Yes 0 No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> 1Z Yes 0 No* Was the testing apparatus properly calibrated? <br /> * Yes 0 No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> 0 N/A <br /> * Yes 0 No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> 0 N/A <br /> * Yes 0 No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> 9 N/A or disconnected? <br /> * Yes 0 No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system <br /> Z N/A malfunctions or fails a test? <br /> 10 Yes 0 No* For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> L0 N/A <br /> _1�_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 /> H. Comments: <br /> Unleaded system is pressurized, Diesel is safe suction. <br /> Page 3 of 3 <br /> UN-036-3/4 www.unidecs.org Rev.01/17/08 <br /> ESH-EFA-TKS-1 8-1 5666-SM/EM:mw <br />