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Oonitoring System Certification Site Address: 3633 DUCK CREEK DRIVE Date of Test!nglService: 40/31/2001 F. In-Tank Gauging 1 SIR Equipment Check this box if tank gauging is used only for inventory control. rr 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. Complete the following checklist: �Yes No" Has all input wiring been inspected for proper entry and termination,including testing for ground faults? 'X Yes No* Were all tank gauging probes visually inspected for damage and residue buildup? l Yes No• Was accuracy of system product level readings tested? Yes No•' Was accuracy of system water level readings tested? s ._ Yes 1.7 No•; Were all probes reinstalled properly? I .......�...............................;......................................................................................................._..................... .............................................................................. Yes No Were all items on the equipment manufacturers maintenance checklist completed? " In the Section H,below,describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD) : Check this box if LLDs are not Installed. Complete the following checklist: For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance? Yes No' N1A`Check all that apply)Simulated leak rate: 3 g.p.h D.t g.p.h C]0.2 g.p.h Yes No Were all LLDs confirmed operational and accurate within regulatory requirements? Yes No ;Was the testing apparatus properly calibrated? Yes No N/A For mechanical Lli does the LLD restrict product flow if it detects a leak? YesN6• NIAI For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? Yes No• [7,NIA For electronic Li does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? Yes `x.�No' . . NIA;For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? Yes No N!A For electronic LLDs,have all accessible wiring connections been visually inspected? yes • 's Were all items on the equipment manufacturers'maintenance checklist completed? "In the Section H,beYow,describe how and when these deficiencies were or will be corrected. H. Comments: page 3 of 3 w