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SEP 12 Z011-0 <br /> t� h <br /> F. In-Tank Gauging I SIR Equipment: 0 Check this box if tank gauging is used only for inventory 6ttrbA. m� � <br /> ❑ Check this box if no tank gauging or SIR equipment is installed. <br /> This section must be completed it in-tank gauging equipment is used to perform leak detection monitoring. <br /> Complete the following checklist: <br /> Yes ❑ No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> [ Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> Q Yes ❑ No* Was accuracy of system product level readings tested? <br /> E Yes ❑ No` Was accuracy of system water level readings tested? <br /> 0 Yes ❑ No* Were all probes reinstalled properly? <br /> [j Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> *In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> G. Line Leak Detectors(LLD): E) Check this box if LLDs are not installed. <br /> Complete the following checklist: <br /> ® Yes No* For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance? (Check ail <br /> N/A that apply) Simulated leak rate:03 g.p.h.;®0.1 g.p.h ;00.2 g.p.h. <br /> Yes No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> ❑ Yes No* Was the testing apparatus properly calibrated? <br /> YesENo* <br /> For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> ® Yes For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> El Yes ® No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or <br /> N/A disconnected? <br /> E] Yes ® No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or <br /> N/A fails a test? <br /> Yes No For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> N/A <br /> E] Yes JEJ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> .in the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: <br /> Monitoring System Certification Page 3 of 4 12107 <br /> 3 2/21/07 <br />