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Monitoring System Certification 0 :1 lHh . In -Tank Gauging / SIR Equipment: ® Check this box if tank gauging is used only for inventory control. ❑ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: ❑ Yes ❑ No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? ❑ Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? ❑ Yes ❑ No* Was accuracy of system product level readings tested? ® Yes ❑ Yes ❑ No* Was accuracy of system water level readings tested? ❑ Yes ❑ No* Were all probes reinstalled properly? JAN 3 0 2015 ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): Cmmnlete the followinu checklist! ❑ Check this box if LLDs are not installed. ® Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? ❑ N/A (Check all that apply) Simulated leak rate: ® 3 g.p.h.; ❑ 0.1 g.p.h ; [10.2 g.p.h. ® Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? ® Yes ❑ No* Was the testing apparatus properly calibrated? ® Yes ❑ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ❑ N/A ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ® N/A ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled ® N/A or disconnected? ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system ® N/A malfunctions or fails a test? No* For electronic LLDs, have all accessible wiring connections been visually inspected? EYesYeF1® N/A ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: