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11 <br />Monitoring System Certification 016— <br />F. <br />In -Tank Gauging / SIR Equipment: ❑ 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 in -tank gauging equipment is used to perform leak detection monitoring. <br />Com lets the foil jug checklist: <br />0 Yes 0 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 />® Yes ❑ No* Was accuracy of system product level readings tested? <br />E Yes ❑ No* Was accuracy of system water level readings tested? <br />® Yes ❑ No* Were all probes reinstalled properly? <br />® 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): ® Check this box if LLDs are not installed. <br />Com late the foliowia checklist: <br />annual equipment certification, was a leak simulated to verify LLD performance? <br />O Yes ❑ No* For equipment start-up or <br />that apply) Simulated leak rate: RI 3 g.p.h.; O 0.1 g.p.h; ❑ 0.2 g.p.h. <br />❑ N/A (Check all <br />O Yes <br />O No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />❑ Yes <br />O No* <br />Was the testing apparatus properly calibrated? <br />❑ Yes <br />O No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />O Yes <br />O N/A <br />O No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />❑ Yes <br />❑ N/A <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />❑ N/A <br />or disconnected? <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system <br />❑ N/A <br />malfunctions or fails a test? <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />❑ Yes <br />❑ No* <br />0 Yes <br />O N/A <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />*In the Section tt, aeiow, aescrioe now anu weec,® ancac uc.....c.....v •-. • — • -__ _ _ __ _ _ _ _ _ <br />H. Comments: <br />UN -036 - 3/4 Page 3 of 4 Rev. 06/04/01 <br />www.onidocs.ore <br />