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• 4b <br /> F. In-Tank Gauging I SIR Equipment: ® Check this box 0 tank gauging is used only for inventory coLIAR 16 2016 <br /> ❑ Check this box'rf no tank gauging or SIR equipment is Installed.('p `r.y r��ry' <br /> This section must be completed if in4ank gauging equipment is used to perform leak detection monitoring. ENVIRONMENTAL <br /> V I V M Et V 11t 1 <br /> Complete the following checklist: <br /> ❑ Yesro* Hasall input wiring been inspected for proper entry and termination,inGuding testing for ground faults? <br /> ❑ Yes all tank gauging probes visually inspected for damage and residue buildup? <br /> ❑ Yesaccuracy of system product level readings tested? <br /> ❑ Yes accuracy of system water level readings tested? <br /> ❑ Yes all probes reinstalled properly? <br /> ❑ Yes all items on the equipment manufacturers maintenance checklist completed? <br /> In Section H,below,describe how and when these deficiencies were or will be corrected. <br /> Line Leak Detectors(LLD): ❑ Check this box R LLDs are not installed. <br /> Com tete the followin checklist: <br /> ® Yes ❑ No' For equipment start-up or annual equipment certification, was a as simulated to ver i y LLD performance? (Check all that apply) <br /> ❑ N/A Simulated leak rate: ®3 g.p.h.; ❑0.1 g.p.h; [10.2 g.p.h. <br /> ® <br /> Yes ❑ No` Were all LIDS confirmed operational and accurate within regulatory requirements? <br /> ® Yes ❑ No' Was the testing apparatus properly calibrated? <br /> ® Yes ❑ No- For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> ❑ N/A <br /> ❑ Yes ❑ No' For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> ® N/A <br /> ❑ Yes ❑ No' For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br /> ® N/A <br /> ❑ Yes ❑ No' For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? <br /> ® N/A <br /> ❑ Yes ❑ No' For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> ® N/A <br /> ® Yes ❑ No' Were all items on the equipment manufacturers maintenance checklist completed? <br /> 'In Section H,below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: <br /> Jet a north 320 5 25 13 <br /> Jet middle 280 4 21 24 15 <br /> Jet a south 375 5 30 21 <br /> Monitoring System Certification Page 3 of 4 2/21/07 <br />