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F. 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 />Complete the following checklist: <br />❑ Yes <br />❑ <br />No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faul <br />❑ Yes <br />❑ <br />No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? .; n <br />❑ Yes <br />❑ <br />No* <br />Was accuracy of system product level readings tested? <br />❑ Yes <br />❑ <br />No* <br />Was accuracy of system water level readings tested? <br />❑ Yes <br />❑ <br />No* <br />Were all probes reinstalled properly? <br />❑ Yes <br />❑ <br />No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />-in section n, oelow, aescrine now ano wnen tnese aenciencies were or will ne correctea. <br />Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />[:n—loto tha fnllnwrnn rharlrlist- <br />® Yes <br />❑ No* <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) <br />❑ N/A <br />Simulated leak rate: ® 3 g.p.h.; ❑ 0.1 g.p.h ; [10.2 g.p.h. <br />® Yes <br />❑ No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />® Yes <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />® Yes <br />❑ No* <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 />® N/A <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br />® N/A <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? <br />® N/A <br />❑ Yes <br />❑ No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />® N/A <br />® Yes <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />- in section n, oeiow, oescnoe now ano wnen mese oenclencles were or win tie correctea. <br />H. Comments: <br />ALL 3 LDS PASSED <br />Monitoring System Certification Page 3 of 4 2/21/07 <br />