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11 <br /> _ r�Eor�.gcrioN O �v��f/p/7 a�°r9r 4ppe�d <br /> Underground Storage Tank 46 <br /> Monitoring Sy►stem Certification Form <br /> TANK GAUGING TESTING <br /> eck this box if tank gauging is used only for inventory control. <br /> ®deck this box if NO tank gauging equipment is installed. <br /> 0 00 not coin fete this section if either box is checked. Yes No NA <br /> AllVyirin9 has been. 1) visually inspected for kinks, breaks and proper entry and <br /> ie�mination, and 2 tested for round faults-,.here all in-tank gauging probes visually inspected for damage and residue buildup ❑ ❑ ❑ <br /> Ito ensure that floats move freely, functionally_tested, and confirmed o erational? �� ❑ ❑ <br /> Was;c 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? ❑ ❑ ❑ <br /> Probe ID be Model ❑ <br /> Tanks Monitored Pass Fail <br /> CCOMMENTS — -- <br /> ❑ ❑ <br /> Describe all answers marked "No"or"Fail"and proposed remedy. <br /> List all monitoring equipment either� replaced or repaired.� DSL_/E-85 Split An p <br /> p Annular failed testing, need to return to replace and retest <br /> ' DSL. Leak detector failed testing, need to return to replace and retest <br /> tib <br /> 3f�/fie <br /> �q< <br /> Page 5 of 6 <br />