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F. ln-Tank Gauging i 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 perform leak detection monitoring. <br /> Complete the following checklist: <br /> ® You ❑ NW Has all Input wiring been inspected for proper entry and termination, including testing forgroundfaults? <br /> 19 Yes ❑ No` Were all tank gauging prones %Asually inspected for damage and residue buildup? <br /> 19 Yes ❑ No' Was accuracy of system product level readings tested? <br /> ® Yes ❑ Noe Was accuracy of system water level readings tested? <br /> ® Yee ❑ No` Were all probes reinstalled property? <br /> WIN <br /> Yes ❑ 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 /> Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed . <br /> Com plate the followingchecklist: <br /> �I Yes ❑ Noe For equipment startup or annual equipment certification, was a leak simulated to verify LLD perfomlance? (Chock all that apply) <br /> ❑ <br /> NIA Simulated leak rate: 0 3 g. p.h.; ❑ 0. 1 g p.h , ❑ 0.2 g.p. h <br /> ® Yes ❑ Noe Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> ® Yes ❑ No" Was the testing apparatus properly earibmtod? <br /> ® Yes ❑ Noe For mechanical LLDs, does the LLD restrict product flow if It detects a leak? <br /> ❑ <br /> NIA <br /> Q Yes ❑ No` <br /> N/A For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br /> �] <br /> ❑ Yes ❑ Noe For electronic LLDs, does the turbine automalioaxy shut off if any portion of the monitoring system Is disabled ortisconnected? <br /> �{ NiA <br /> ❑ Yes ❑ Noe For electronic LLDs , does the turbine automatically shut off if any portion of the monitoring system melfuncfiens or fails a test? <br /> 0 NIA <br /> ❑ Yes ❑ No` For electronic Llds, nava all accessible wiring connections been visually Inspected? <br /> ® NIA <br /> �$ Yes ❑ No' Were all items on the equipment manufacturer's maintenance checklist completed? <br /> jIn Section H, below, describe how and when these deficiencies were or will be corrected. <br /> H. Comments: <br /> i <br /> i <br /> i <br /> F <br /> Moniboring System Certification Page 3 of 4 2121107 ' <br /> . . .r A . n nn n� > n I inn <br />