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04/1212012 12:42 i2091465-442vO Wayne Henderson Page 315 F. In -Tank Gauging 1 SIR Equipment. ® Check this box it 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 following checklist: ❑ Yes ❑ No' Has all input wiring been Inspected for proper entry and termination, including testing for ground faults? ❑ Yes ❑ No. Were all tank gauging probes visually inspected for damage and residue buildup? ❑ Yes ❑ No' Was accuracy of system product level readings tested? ❑ Yes ❑ No' Was accuracy of system water level readings tested? ❑ Yes ❑ No, Were all probes reinstalled property? ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? -in oaCUOn r/, uelow, Heicrlue riow apu when (nese uen{8e0ulei wale VI will Ke is Vl le4a<V. Line Leak Detectors (LLD): ® Check this box 4 LLDs are not installed. Complete the foilowina checklist: ❑ Yes ❑ No' For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all the: apply) ❑ NIA 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? ❑ Yes ❑ No' Was the testing apparatus properly calibrated? ❑ Yes ❑ No' For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ❑ N/A ❑ Yes ❑ No" For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ❑ NIA ❑ Yes ❑ No- For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? ❑ NIA ❑ Yes ❑ No" For electronic LLDs. does the turbine automatically shut off if any portion of the monitoring system malfunctions or faits a test? ❑ NIA ❑ Yes ❑ No' For electronic LLDs, have all accessible wiring connections been visually inspected? ❑ NIA ❑ Yes ❑ No` Were all items on the equipment manufacturer's maintenance checklist completed? - in ciection n, oalow, oescnoe now ana when tnese oenumouiva were ul wnl ue can V.— H. Comments: SUCTION Monitoring System Certification Page 3 of 4 2121101