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I1tgSystem Certification <br />dress: _ y 2 N I I OVI r c= .t �,, IL4 . <br />Date of'rest ing/Servicing:Qj—/ 3/D -U <br />'funk Gauging / SIR Lgttipment:Check this box if tank gauging is used only for invento "cont l <br />❑ Check this box if no tank gauging or SIR equipment is installed. <br />ssection must be completed i( in-I,inlc gangling equipment is used to perform leak detection monitoring.. . <br />plete the following checiclist: <br />16s ❑ No* Has all input wiring been inspected for proper enti and termination, including testing for ground faults? <br />'es 13 No* Were all tank gaubmg �n-obes visually inspected for damage and residue buildup? <br />9 ❑ No* Was accuracy of system product level readings tested? <br />No* I Was accuracy of system water level readings tested? <br />❑ No* Were all probes reinstalled properly'? <br />Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br />- - --- <br />ill the 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 />#06the following checklist: <br />®No* For equipment steal -up or annual equipme t certification, was a leak simulated to verify LLD petfonnance7 <br />(Check all that appy,) Simulated leak rate: 3 g.p.h.; ❑ 0.1 g.p,h ; ❑ 0.2 g.p.h. <br />--. <br />trV'No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br />❑ No* Was the testing apparatus properly calibrated? <br />§` ❑ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />N/A <br />l}. o* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? L <br />N/A F <br />l ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring s stem is disc <br />or disconnected? Y bled. <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitorings stem <br />'malfunctions or fails a test? y <br />tt* For electronic LLDs, have all accessible wiring connections been visually inspected? <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />tSeCtibh H, below, describe how anal When these deficiencies were or will be corrected. <br />j' Nil tits: . <br />M!L 3� <br />