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140714-197 F. 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. ComD[ete the follow]no checklist: IN Yes No` Has all input wiring been inspected for proper entry and termination, including testing for ground faults? N/A Yes Nd Were all tank gauging probes visually inspected for damage and residue buildup? e Yes TF No' Was accuracy of system product level readings tested? * Yes Na' Was accuracy of system water level readings tested? e Yes No' Were all probes reinstalled properly? For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? Yes No' Were all items on the equipment manufacturer's maintenance checklist completed? - in the section tf, beiaw, oescrioe now and wnen tnese denciencies were or wni De corrected. G. Line Leak Detectors (LLD): 9 Check this box if LLDs are not installed. Pn,nnlnfn li.® 4n11Muiean whm.4nc!• IN AMMIlL'I IN Yes No' For equipment start-up or annual equipment certification, was a leak simulated to verify LLD pe f N/A that apply) Simulated leak rate: 03 g.p h.; E] 0.1 g.p.h ; []0.2 g.p.h. Yes TF 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 it it detects a leak? NIA Yes No' For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? WA Yes No" For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or N/A disconnected? Yes No. For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or -; WA fails a test? Yes Ej No' For electronic LLDs, have all accessible wiring connections been visually inspected? N/A 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. H. Comments: Monitoring System Certification Page 3 of 4 12/07 3 2/21/07