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130620-293 <br />F. in -Tank Gauging / SIR Equipment: ii 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 in4ank gauging equipment Is used to perform leak detection monitoring. <br />A -22-2— <br />s Yes <br />r3 No` <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />m Yes <br />® No- <br />Were all tank gauging probes visually Inspected for damage and residue buildup? <br />51 Yes <br />No` <br />Was accuracy of system product level readings tested? <br />Yes <br />No' <br />Was accuracy of system water level rungs tested? <br />Yes <br />No` <br />Were all probes reinstalled property? <br />� Yes <br />No" <br />Were all items on the equipment manufacturers maintenance checklist completed? <br />In the Section H, below, describe flow and wnen tnese oenctencies were or wni oe correcma. <br />G. Line Leak Detectors (LLD): R Check this box if LLDs are not installed. <br />® Yes <br />No• <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all <br />N/A <br />that ) Simulated leak rate: ®3 g p.h.; ®0.1 g.p.h ; 13 0.2 g.p.h. <br />Yes <br />No' <br />Were all LLDs confirmed operational and agate within regulatory requirements? <br />Yes <br />No` <br />Was the testing apparatus properly calibrated? <br />13 Yes <br />1W <br />For mechanical LLDs, does the LLD restrict product flow If it detects a leak? <br />N/A <br />Yes <br />No' <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />WA <br />Yes <br />NO* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or <br />WA <br />disconnected? <br />Yes <br />No` <br />For AxAmnic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or <br />WA <br />falls a test? <br />Yes <br />No' <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />13 WA <br />Yes <br />a No` <br />I Were ail Reins on the equipment manufacturer's maintenance checklist completed? <br />A 1T --V ' UM11;A71F,7M--r--,7 iIc77Ti TZ;.. � Ii- I11 -Mf a, ]IN![ lA"I .r.z•:r ^iEn•=i«.•�wr :�c .,, <br />H. Comments: <br />Suction system. <br />Monitoring System Certification Rage 3 of 4 <br />12J07 <br />3 2/21/07 <br />