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ARAVEL Monitoring System Certification-Page 3 of 3 JUL 01 2015 ,Ia Site Address: 1409 S Airport Way sting^/Servicing: 616/13((JJ �Nr1 1!eelTu n�7POTA[elT F. In-Tank Gauging/SIR Equipment: ® 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 gauging equipment is used to perform leak detection monitoring. FEDYes e the followingchecklist: ❑ No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup?❑ No* Was accuracy of systemproduct level readings tested?❑ No* Was accuracy of system water level readings tested?❑ No* Were all probes reinstalled properly? ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? *In Section H below,describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors(LLD): ❑ Check this box if LLD's are not installed. Com let e the following checklist: ertification was a leak simulated to verify LLD performance? ® Yes ❑ No* For equipment start-up or annual equipment c ❑ N/A (Check all that apply) Simulated leak rate: ® 3 g.p.h.(1.); ❑ 0.1 g.p.h.(2.); ❑ 0.2 g.p.h.(2.).. Notes: 1. Required for equipment start-up certification and annual certification. 2. Unless mandated by local agency,certification required onlyfor electronic LLD start-up. ® Yes ❑ No* Were all LLD's confirmed o erational and accurate within regulatory requirements? ® Yes —E No* Was the testing apparatus properly calibrated? ® Yes ❑ No* For mechanical LLD's,does the LLD restrict product flow if it detects a leak? ❑ N/A ❑ Yes ❑ No* For electronic LLD's,does the turbine automatically shut off if the LLD detects a leak? ® N/A ❑ Yes ❑ No* For electronic LLD's,does the turbine automatically shut off if any portion of the monitoring system is disabled o N/A or disconnected? ❑ Yes ❑ No* For electronic LLD's,does the turbine automatically shut off if any portion of the monitoring system ® N/A malfunctions or fails a test? ❑ Yes ❑ No* For electronic LLD's,have all accessible wiring connections been visually inspected? ® N/A ® Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In Section H below,describe how and when these deficiencies were or will be corrected. H. Comments: