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d <br /> F. In-Tank Gauging/SIR Equipment: ® Check this box'rftank gauging is used only for inventory control. <br /> ❑ Check this box if no tank gauging or SIR equipment is instal" 0 3 2016 <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. <br /> Complete the following checklist: - <br /> Yes _ No` Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> Yes No' Were all tank gauging probes visually inspected for damage and residue buildup? <br /> i Yes 1, No' Was accuracy of system product level readings tested? <br /> Yes No' Was accuracy of system water level readings tested? <br /> n Yes ❑ No' Were all probes reinstalled property? <br /> Yes " No' Were all items on the equipment manufacturer's maintenance checklist completed? <br /> `In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> G. Line Leak Detectors(LLD): F- Check this box if LLDs are not installed. <br /> Complete the following checklist: <br /> ® Yes C No' For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance?(Check all <br /> ❑ N/A that apply) Simulated leak rate: m 3 g.p.h.; n 0.1 g.p.h; n 0.2 g.p.h. <br /> ® Yes ❑ No' Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> ® Yes C 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 /> u Yes J 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 <br /> ® NIA disconnected? <br /> ❑ Yes a No' For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or <br /> ® N/A fails a test? <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 manufacturer's maintenance checklist completed? <br /> *In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: <br /> Monitoring System Certification Page 3 of 4 12107 <br /> a 2/21/07 <br />