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F. in-Tank Gauging I SIR Equipment: ® Check this box if tank caul is used oi ly for inventory control. <br /> ❑ Check this box If no lank gauging oe SIR equipment i> Installed. <br /> This section must be completed if in-tank gsugina eq4 pment is used to perform leak detection monitoring. <br /> Complete the following checklist: <br /> p Yes ❑ No" Has all input wiring"erl spechM for proper entry and termination,including testing for ground fault ? <br /> ❑ Yes ❑ No" Were all tank gauping p, lea visually inspected for damage and residua buildup? <br /> ❑ Yes ❑ No' Was accuracy of aysterr: 'oduct level readings tested? <br /> ❑ Yes ❑ No, Was accuracy of syslern ater level readings tested? <br /> I ❑ Yes ❑ No' Were all probes rwnwaV" propel <br /> Q Yea ❑ No' Were all deme on the ec• )ment manufacturer's maintenance checklist cornoloted? <br /> in Section kr,bellow,deecribe how end when these de ciencles were or will be corrected. <br /> Line Leak Detectors tLLD): © Check this box If L,LDs are not installed, <br /> Complete the followin checklist! <br /> 0 Yes ❑ No' For equipmentStart-up� annual equlpment certification, was s +eak simulated to verify LLD pe ormance? (Check all that apply) <br /> ❑ NIA Simulated leak rate: [0 3.p.h, ❑0.1 g p.h; ❑0.2 g.p.h. ! <br /> 23 Yes ❑ No" were all i lL-bs confirrnad perational anp,a=rate within regulatory requrremiarits? <br /> ® Yes ❑ No' Was the testing apparel j properly calibrated? <br /> ® Yee ❑ No' For machanieal LLRc,d3 :the LLD restrict product Pow if it detects a leak? <br /> Q NIA <br /> D YeS ❑ No' For electronic LLl the turbine automeltiCally Shut orr it the LLD detects a leak? <br /> ® NIA <br /> L Yes ❑ No' For electronic Li.Ds,doc� ;he turbine automatically shut off if any porton of the monitoring systern is i9abled or di9conf aCtetl? i <br /> ® NrA !I <br /> ❑ Yes ❑ No' For electronic LLDS,doe, :he turbine automatically shut off if any portion of the monitoring system m Ifunctions.or falls a test? <br /> N/A <br /> Yes D No- For electronic t.Lds,hati'� 3U accessible wiring connections been visually inspected? <br /> ® <br /> NA <br /> Yefi ❑ No' Were all items on the eq uj )Ment r nanufacturer's maintenance cheokllyt eortinleted'P <br /> 'In Section W,below,describe how and when these d clencles were or will he corrected. <br /> i <br /> 1- CBmmBnts: � i <br /> I <br /> i <br /> 1 <br /> ( <br /> l <br /> J <br /> 1 <br /> i <br /> RI <br /> _l <br /> Monitoring Systl Cartlflcation Page 3 of 4 2/21107 <br /> i <br /> I <br /> I <br /> ) <br /> E <br /> Z 39dd sisvoI01f1C Icor lI0 898L696GOZT ST :Z8 0TOZ19Z1'48 <br />