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onitoring System Certification <br /> Site Address: 1103 S. MAIN ST. Date of Testing/Service: 06/11/2001 <br /> F. In-Tank Gauging /SIR Equipment ❑ Check this box if tank gauging is used only for inventory control. <br /> ❑ 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 preform leak detection monitoring <br /> Complete the following checklist: <br /> ® Yes ❑No• Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> ® Yes ❑No= Were all tank gauging probes visually inspected for damage and residue buildup? <br /> ® Yes ❑No= Was the accuracy of system product level readings tested? <br /> ®Yes ❑No= Was accuracy of system water level readings tested? <br /> ® Yes ❑No= Were all probes reinstalled properly? <br /> ® Yes E]No= Were all items on the equipment manufacturer's maintenance checklist completed? <br /> G. Line Leak Detectors (LLD) : ❑ Check this box if no tank gauging or SIR equipment is installed. <br /> Complete the following checklist: <br /> For equipment start-up or annual equipment certification,was a leak simulated to verify performance? <br /> ® Yes ❑ No= ❑N/A (Check all that apply)Simulated leak rate:®3 g.p.h❑0.1 g.p.h ❑0.2 g.p.h <br /> ❑ Yes ® No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> ® Yes ❑No• Was the testing apparatus properly calibrated? <br /> ®Yes ❑No• ® N/A For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> ❑Yes ❑No* ❑ N/A For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> ®Yes ❑No• ❑ N/A For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br /> Yes No` N/A For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test., <br /> ®Yes ❑No= ❑ N/A or electronic LLDs,have all accessible wiring connections been visually inspected? <br /> ®Yes ❑No= ere all items on the equipment manufacturer's maintenance checklist completed? <br /> =In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: <br /> super does not shut down on 3gph only gross fail <br /> page 3 of 3 <br />