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'Auk <br /> Monitoring System Certification-Page 3 of'3 <br /> Site Address: 3725 N.Tracy Blvd. Date of Testing/Servicing: 1215111 <br /> F. In-Tank Gauging SIR Equipment: Check this box if tank gauging is used only for inventory control. <br /> 11 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 /> Com lete the foliowin checklist: Z <br /> 0 Yes 11 No* Has all input wiring been inspected for proper entry and termination,includitesting for ground faults? <br /> ii Yes 0 No* Were all tank gauging probes visually inspected for damage and residue1/dup.? <br /> a Yes 0 No* Was accuracy of system product level readings tested? <br /> 0 Yes 0 No* Was accuracy of system water level readings tested? <br /> 11 Yes 0 No* I Were all probes reinstalled properly? <br /> ere all items on the equipment manufacturer's maintenyt(ce checklist completed? <br /> In Section H below,describe how and when these deficiencies were will be corrected. <br /> G. Line Leak Detectors(LLD): heckthis box if LLD's are not installed. <br /> Com tete the foliowin checklist: <br /> • Yes 0 No* For equipment start-up or annual e i menti certification was a leak simulated to verify LLD performance? <br /> annual <br /> 13 N/A (Check all that apply) Simulate eak rate: 0 3 g.p.h.(1.); 0 0.1 g.p.h.(2), 0 0.2 g,p,b.(1). <br /> Notes: 1. Required for eq/iment start-up certification and annual certification. <br /> 2. Unless manda d by local agency,certification required only for electronic LLD start-!zp, <br /> • Yes 0 No* Were all LLD's confirm fi42perational and accurate within regulatory requirements? <br /> • Yes 0 No* Was the testing appaya/tus pEMerly calibrated? <br /> • Yes 0 No* For mechanical L 's,,does the LLD restrict product flow if it detects a leak? <br /> ci N/A, <br /> 13 Yes 0 No* For electron' LLD's,does the turbine automatically shut off if the LLD detects a leak? <br /> 0 N/A <br /> 0 Yes 0 No* Forel <br /> ,xtronic LLD's,does the turbine automatically shut off if any Portion of the monitoring system is disabled <br /> 11 N/A or dXconnected? <br /> 0 Yes 0 No* electronic LLD's,does the turbine automatically shut off if any portion of the monitoring system <br /> 0 NIA Zrifunctions or fails a test? <br /> 11 No For electronic LLD's,have all accessible wiring connections been visually inspected? <br /> 0 A <br /> Lo" Yy�Yes No*7,(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 /> H. Comments., TLM's&LLD's are monitored by Veeder Root, <br />