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Jan.23. 2015 12:33PM RUMEX CONSTRUCTION <br />Monitoring System Certification 0 0 <br />No.9417 P. 4/8 <br />F. In-TGauging / SIR Equipment: 0 Check this box if tank gauging is used only for inventory control, <br />0 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 />Complete the following checklist, <br />E3 Yes <br />El No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />• Yes <br />El No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />• Yes <br />0 No* <br />Was accuracy of system product level readings tested? A-41ZP.1=111Cr% <br />[@ Yes <br />® Yes <br />0 No* <br />son= am= I V Low Lw�" <br />Was accuracy of system water level readings tested? <br />91 Yes <br />0 No" <br />Were all probes reinstalled properly? JAN 2 3 2015 <br />19 Yes <br />0 No* <br />Were all items on the equipment manufacturer's maintenance checklist compl <br />In the Section H, below, describe bow and when these deficiencies were Or Will be carr MAL4F-A <br />f "rf-j <br />G. Line Leak Detectors (LLD)*. <br />+1- A6_t0H.#. <br />0 Check this box if LLDs are not installed. <br />• Yes <br />0 NoT- <br />For equipment start-up or annual equipment certification. was a leak simulated to verify LLD performance? <br />E] N/A <br />(Cheek all that apply) Simulated leak raw- 9 3 g.p.h,; 0 0.1 g,p.h; 0 0.2 g,p.h. <br />• Yes <br />E) NO <br />Were all LL,Ds confirmed operational and accurate within regulatory requirements? <br />[@ Yes <br />Ej No* <br />Was the testing apparatus properly calibrated? <br />* Yes <br />0 No' <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />0 NIA <br />* Yes <br />0 No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects 4 leak?. <br />0 N/A <br />El Yes <br />[3 No@, <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />Z NIA <br />or disconnected? <br />• Yes <br />El NO <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfimetions <br />ED N/A <br />or fails a test? <br />• Yes <br />0 No* <br />'For electronic LLDs, have an accessible wiring connections been visually inspected? <br />0 N/A <br />0 Yes <br />0 No* <br />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 />MI. Comments: <br />Page 3 of 3 <br />