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F. In-Tank Gauging / SIR Equipment : -x Check this box if tank gauging is used only for inventory control . :1 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? Li Yes a 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 properly? ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected . G . Line Leak Detectors ( LLD) : © Check this box if LLDs are not installed . Complete the following checklist : Cx Yes ❑ No* 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 : 03 g . p. h . ; [EJ0 . 1 g . p. h ; [JO . 2 g . p. h . Lx Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? Cx Yes ❑ No* Was the testing apparatus properly calibrated? Lx 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? ix N/A ❑ Yes ❑ No* For electronic LLDs , does the turbine automatically shut off if any portion of the monitoring system is disabled or [8 N/A disconnected ? ❑ Yes ❑ No* For electronic LLDs , does the turbine automatically shut off if any portion of the monitoring system malfunctions or 1k N/A fails a test? u Yes u No* For electronic LLDs , have all accessible wiring connections been visually inspected? ix N/A rx Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H , below, describe how and when these deficiencies were or will be corrected . H . Comments : Replaced Like For Like Al MLLD ,n Retested And Was Able To Pass No Permit Required . Inspector on site to witness test . Old SN : 17051149 New SN : 18031476 Monitoring System Certification Page of 12/07 I i i