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Underground Storage Tank <br />Monitoring System Certification Form <br />8. IN -TANK GAUGING TESTING <br />® 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 ❑ ❑ ❑ <br />to ensure that floats move freely, functionally 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?El❑ ❑ <br />Probe ID <br />Probe Model <br />Tanks Monitored <br />Pass <br />Fail <br />T-1 <br />VR -Mag Probe <br />Diesel <br />❑ <br />❑ <br />T-2 <br />VR -Mag Probe <br />87 Unleaded <br />❑ <br />❑ <br />T-3 <br />VR -Mag Probe <br />91 Super Unleaded <br />❑ <br />❑ <br />❑ <br />❑ <br />Mag Probes Not Tested <br />❑ <br />❑ <br />on This Certification <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 />This Monitor Certification was for the Dispenser Installation and <br />Veeder-Root Software Upgrade Only <br />This Monitor Certification DOES NOT change there Annual Monitor Cert. Date <br />Leak Detectors Not Tested <br />Mag Probes Not Tested <br />Page 5 of 6 <br />