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V E <br /> F. In-Tank Gauging I SIR Equipment: Check this box if tank gauging is used onlydriken oQtrol. <br /> o Check this box if no tank gauging or SIR equipment is installed. <br /> MAY 12015 <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. MENTA), <br /> #j1i0;00;m <br /> MMCom lots the follow,ng checklist including testing for groun 7j <br /> 0 Yes 0 No* Has all input wiring been inspected for proper entry and termination, <br /> 0 Yes 11 No* Were all tank gauging probes visually inspected for damage an residue buildup? <br /> 0 Yes 0 No* Was accuracy f system product readings tested? <br /> 0 Yes [I No* Was accuracy of system water level readings tested? <br /> 0 e 0 NO- Were all probes reinstalled property? <br /> D Yes ii No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> re or will be corrected. <br /> *In the Section H,below,describe ow and when these deactencles;we <br /> G. Line Leak Detectors(1-1-13): Ei Check this box if LLDs are not installed. <br /> Com tete the follor"win checid'-f- <br /> nec"' <br /> the T p or annual equipment certification,was a leak sim t to verify LLD performance? <br /> (Check aid <br /> 23 Yes 0 No* For equipment start-u <br /> o N/A that apply) Simulated leak rate: R 3 g.p.h.; E,0.1 g.p.h; 0 0.2 g.p.h. <br /> a onal and accura within regulatory requirements? <br /> 0 Yes El No* Were all LLDs confirmed operational <br /> , m"* properly calibrated? <br /> 9 Yes 0 No* Was the testing apparatus pro <br /> 0 Yes 0 No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> 0 N/A a LLD detects a leak? <br /> 0 Yes o No* For electronicLLDs,does the turbine automatically shut off if th <br /> N NIA any portion of the i 11 i ionitoring system is disabled or <br /> :... automaticallyshut Foff 6 <br /> D s 0 Ne For electronic LLDs, does the turbine <br /> Ig N/A disconnected? <br /> 0 Yes 0 No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or <br /> 19 NIA fails a test? <br /> C1 Yes 0 No* For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> 9 Yes 9 N/A Were all items on the equipment manufacturer's maintenance checklist completed? <br /> �Mdeficiencies were or will be corrected. <br /> In the Section H,below,describe how an when th <br /> H. Comments- ARM CONTROLLER HAS BEEN INSTALLED ON DIESEL HIGH FLOW AND LLD WITH ARM WAS <br /> CONFIRMED OPE RATIONAL. ARM IS SET AT 17 IN. TH 600 ML BLEED BACK. <br /> Monitoring System Certification Page 3 of 4 12!07 <br /> 3 2/21/07 <br />