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Monitoring System Certification - Page 3 of 3 Site Address: 13975 E. Hwy 88 F. In -Tank Gauging I SIR Equiptne►►ta Date of Testing/Servicing: 8128118 ® 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. * In Section H below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): ❑ Check this box if LLD's are not installed. Com Tete the followin checklist: ❑ Yes ❑ No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? 0 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? O Yes ❑ No* Were all probes reinstalled properly? ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? Yes ❑ ® No* N/A For mechanical LLD's, does the LLD restrict product flow if it detects a leak? * In Section H below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): ❑ Check this box if LLD's are not installed. Com Tete the followin checklist: ® Yes 0 ❑ No* N/A For equipment start-up or annual equipment certification was a leak simulated to verify LLD performance? (Check all that apply) Simulated leak rate: ® 3 g.p.h. (1.); 0 0.1 g.p.h. (2); 0 0.2 g.p.h. (2.). Notes: 1. Required for equipment start-up certification and annual certification. 2. Unless mandated by local agency, certification required only for electronic LLD start-up. n Yes ❑ No* Were all LLD's confirmed operational and accurate within regulatory requirements? ® Yes 0 No* Was the testing apparatus properly calibrated? ❑ Yes ❑ ® No* N/A For mechanical LLD's, does the LLD restrict product flow if it detects a leak? (g Yes ❑ ❑ No* N/A For electronic LLD's, does the turbine automatically shut off if the LLD detects a leak? ® Yes ❑ 0 No* N/A For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring or disconnected? system is disabled M Yes ❑ ❑ No* N/A For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring malfunctions or fails a test? system L11Yes ❑ ❑ No* N/A For electronic LLD's, have all accessible wiring connections been visually inspected? ® Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In Section H below, describe how and when these deficiencies were or will be corrected. H. Comments: