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i,•'1r If r f f 1 Yr9 �8[-' rY Yr , • ♦ t 1 • •♦• .1 Y 'x.14 !"""�GGG'''M1,�1' •ra r i rr ♦ Lr '!� 1; r 1 tr * f.r - �. ♦, r r , y r r , ,� r + Y,.F ♦..♦ r r r rF F ,'mom ROLr ;n ,h;r F. In -Tank Gauging ! SIR Equiprr i it: i 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 c iu;iing equipment is used to perform leak detection monitoring. Complete the following checklist: _ Yes ❑ No" Has all inpu sir ng been inspected for proper entry and termination, including testing for ground faults? �l Yes ❑ No` Were all tang iauging-probes visually inspected for damage and residue buildup? Yes ❑ No" Was accura, o: system product level readings tested? Yes ❑ No" Was accura,. o system water level readings tested? Yes ❑ No` Were all prc: s einstalled property? Yes ❑ No`Were all item on the equipment manufacturersmaintenance cheddist completed? In the Section H, below, describe hon 3r d when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): C Check this box if LLDs are not installed. Comolete the foilowina'checklist: ' Yes ❑ No" For equipme- ❑ N/A that apply) 5 i Yes ❑ No" Were all LLDs Yes ❑ No' Was the `testi, ❑ Yes ❑ No" For mechanlc .Cl N/A Yes ❑. No* For electronic ❑ N/A Yes ❑ No` For electronic ❑ N/A disconnected 2 jr Yes ❑ No" -Forelectronk ❑ N/A fails -a test? Yes ❑ Ne* For electronic ❑ N/A Yes ❑ No Were all item: :art -up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all ated leak rate: C?�3 g.p.h.; ❑ 0.1 g.p.h; ❑ 0.2 g.p.h. 'ifirmed operational pnd accurate withln regulatory requirements? pparatus properly calibrated? _._.... .._..__......... _ _. . .-Ds, does the LLD restrict product flow if it detects a leak? a, does the turbine automatically shut off if the LLD detects a leak? Ds, does the turbine automatically shut off if any portion of the monitoring system Is disabled or :is, does the turbine automatically shut off If any portion of the monitoring system malfunctions or is, have all accessible wiring connections been visually inspected? the equipment manufacturer's maintenance checklist completed? . ----- * In theSection-N;-below; describe -how; re when-these-deficiencies-were-or.wiil-be-corrected.- - - •- H. Comments: r Monitoring System Certification Page 3 of 4 3 Y , t:'d Z�E919�60Zi sJO4Oe-4uo0 AI 91itA 12107 2/21/07 Y C110 :21 61 LZ qa-A