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Gf rrait -RYAN INC. GR Job # 20-601659 F. In -Tank Gauging / SIR Equipment: [I Check this box if tank gauging is used only for inventory control. ❑ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if In -tank gauging equipment is used to perform leak detection monitoring. Complete the foilowino checklist: IX es ❑ o Has all input wiring been inspected for proper entry and termination, including testing for ground faults? ff Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? [j Yes ❑ No* Was accuracy of system products level readings tested? (Z Yes ❑ No* Was accuracy of system water level readings tested? [g Yes ❑ No* Were all probes reinstalled properly? a Yes 1 ❑ No* lWere all items on the equipment manufacturer's maintenance checklist completed? - in ine aecuon n, oeiow, oescrroe now aro wren uiese oencrencres were or viii oe correccea. G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. Cmmnlete the faiinwina checklist: - in cne aec:oon n, oerow, aescrroe now ana wnen urese aenc'encees were or wne oe correccea. G. Comments: Monitoring System Certification Page 3 of 4 12/07 10 Yes ❑ o For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (check all ❑ N/A that apply) Simulated leak rate: ® 3 g.p.h. ❑ 0.1 g.p.h. ❑ 0.2 g.p.h. Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? (i Yes ❑ No* Was the testing apparatus property calibrated? ❑ Yes ❑ No* For Mechanical LLDs, does the LLD restrict product flow if it detects a leak? N/A rg Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ❑ N/A rL Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or ❑ N/A Disconnected? Ij Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or ❑ N/A fails a test? Ii Yes ❑ No* For electronic LLDs, have all accessible wiring connections been visually inspected? ❑ N/A ff Yes ❑ No* were all items on the equipment manufacturer's maintenance checklist completed? - in cne aec:oon n, oerow, aescrroe now ana wnen urese aenc'encees were or wne oe correccea. G. Comments: Monitoring System Certification Page 3 of 4 12/07 10