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Underground Storage Tank RECEIVED <br /> Monitoring System Certification Form JAN 0 7 2022 <br /> 8 IN TANK GAUGING TESTING HEALTH DEPARTMEN <br /> O Check this box if tank gauging is used only for inventory control . <br /> ❑ Check this box if NO tank gauging equipment is installed . Yes No NA <br /> Do not complete this section if either box is checked. <br /> All wiring has been : 1 ) visually inspected for kinks , breaks and proper entry and ❑ ❑ ❑ <br /> termination ; and 2 tested for ground faults? <br /> Were all in -tank gauging probes visually inspected for damage and residue buildup El El 11to ensure that floats move freely , functional ) tested , and confirmed operational . <br /> Was accuracy of system ' s product level readings tested ? ❑ ❑ ❑ <br /> Was accuracy of system ' s water level readings tested ? ❑ ❑ ❑ <br /> Were all probes reinstalled properly? ❑ ❑ ❑ <br /> Were all items on the equipment manufacturer' s maintenance checklist completed ? ❑ ❑ 1 ❑ <br /> Probe ID Probe Model Tanks Monitored Pass Fail <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> 9 COMMENTS <br /> Describe all answers marked "No " or "Fail" and proposed remedy. <br /> List all monitoring equipment either replaced or repaired. <br /> Page 5 of 6 <br />