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Monitoring System Certification <br /> Address: 1617 W FREMONT STOCKTON 952032038 Service Date: 10/03/2008 <br /> 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 fo owing checklist <br /> ®Yes ❑No* Has all input wiring been inspected for proper entry and termination,including testing for ground <br /> faults? <br /> ®Yes D 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 /> ®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 manufacturers 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 /> Complete the fo owinq checklist <br /> ®Yes ❑No* For equipment start-up or annual equipment certification,was a leak simulated to verify LLD <br /> performance? <br /> ❑N/A Simulated Leak Rate(check all that apply) 03.0 g.p.h ❑0.1 g.p.h ❑0.2 g.p.h <br /> ®Yes ❑No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> ®Yes O No* Was the testing apparatus properly calibrated? <br /> ®Yes ❑No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br /> ❑N/A <br /> ®Yes ❑No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> 1 <br /> ❑N/A <br /> ®Yes ❑No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is <br /> disabled or disconnected? <br /> El N/A <br /> For electronic LLDs,does the turbine automaticallyshut off if • <br /> ®Yes D No* malfunctions or fails a test? any portion of the monitoring system <br /> ❑N/A <br /> ®Yes ❑No* For electronic LLDs, have all accessible wiring connections been visually inspected? <br /> ❑N/A <br /> ®Yes ❑No* Were all items on the equipment manufacturers maintenance checklist completed? <br /> *In the Section H below,describe how and when these deficiencies were or will be corrected <br /> H. Comments <br /> All functions normal on TLS 350 therefore no ground faults present. <br /> There is one electronic&one mechanical leak detector installed. <br /> s <br /> Page 3 of 4 <br />