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Jan 10 03 02:22p Ca tie Brown 120 461-6342 p.4 <br />01/02/1995 03:21 709754 722 fALA11ERA5 ENVHEAL PAGE 03 <br />IIIV-Nioultoring System CertidctatIOD <br />Facility Name: kx 6a <br />F. In -Tank Garaging Equipment: <br />0 Qcck this box X tank gauging is used only for inventory control. <br />'Kris section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. <br />Software Version Installed. <br />CO lets we wuOwln cnccw+.a. <br />NR ® Yes C) No- Has all iupot wiring bee! inspected for proper entry and testairratioA, including .....test for ground faWrs? <br />Ycs ® No" Were ail tank gauging probes visually inspected for damage and residue buildup? <br />Yes ❑ No. Was accuracy of system product/waste level readings tested? <br />Yes Q No- Was accuracy of system Wats level readings tested'. <br />Xcs Q No- Wt a+o all ,,Iw s acnvared and did they funcU0n properly? <br />® yes ®No° Wase all isemcs on the equipment manufacturer's riamtroalce checklist completed? <br />In the Section IL below, desenbe how and when these deftciendes were or will be corrected. <br />G, Line Leak Detectors (LLD): 0 Chcck this box if LLDs ate not installed. <br />�r..rnntoto the foliowitar cbecklist: - i <br />® Yes <br />❑ No• <br />Was a leak simulated to verify LLA perform*oce? (Check au rear aFFt37 <br />®No- <br />Simulated kak rate: 103 g P.b.; 0 0.1 g -P. ; ❑ 0.2 g•p.h. <br />Wereail LLDs confirmed operational and accurate vrithia regulatory requixcmenu? <br />ipl Yes <br />Yes <br />O No- <br />Was thetesting apparatus properly caisbnted2 <br />Yes <br />Q No- <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />N/A <br />❑ No' <br />For electronic LLDs. does the turbine autotnaticslly shut of£if the LLD da:ccts a lack? <br />rcc,"Q <br />N/A No- <br />For LLDs, does the rlubine automatically shut off if any portion of themonitoringsystem is dinbled <br />13 N/a <br />or o ed? <br />Y": <br />d No' <br />For electronic LLI3s, docs the turbilc automatically shut off if any portion of the moult system <br />NIA <br />ovs Or falls a test? <br />®No® <br />For electronic LLDs, have ail acccssihic wiring eoont coons been visually inspected? <br />0 N/A <br />r�' <br />® No. <br />If necessary to proper equipment operation. arc ¢art fitters in good cotlditio!? <br />Q N/A <br />® lso- <br />Were all items on the equipment manufacturer's maintenance checklist compicted? <br />..:a •.e ...,...ter...: <br />- In the Section ki, Oel*w, aescreae !vw au,...,.c., <br />H. Comments: <br />CALM -at fate 3 <br />