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0 <br />F. In -Tank Gauging f SIR Equipment: Z Check this box if tank gauging Is used only for inventory control. <br />❑ Check this box if no tank gauging or SIR equipment is installed. <br />This section most be completed if in -tank gauging equipment is used to perform leak detection monitoring. <br />Com lete the following checklist: <br />Z Yes ❑ No' Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />YesF[O-INo* <br />Were all tank gauging probes visually inspected for damage and resrdue buildup? <br />Yes Was accuracy of system product level readings tested? <br />Yes Was accuracy of system water level readings tested? <br />Yes Were all probes reinstalled properly? <br />Yes Were all items nn tt,P on --m <br />' In the Section H, below, describe how and when these deFiciencies were or will be corrected. <br />G. Line Leak Detectors (LLD):Mechanical El Check this box if LLDs are not installed. <br />Com tete the;ooTcneVcK,,s <br />t: <br />® Yes <br />quipment startup or annual equipment certification, was a leak simulated to verity LLD performance? (Check all <br />pply) Simulated leak rate: ® 3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />Yes <br />all LLDs confirmed operational and accurate within regulatory requirements? <br />Yesthe <br />testing apparatus properly calibrated? <br />Yesechanical <br />LLDs, does the LLD restrict product flow if a detects a leak? <br />❑ N/A <br />Yes <br />No' <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />® NIA <br />Yes <br />No" <br />® NIA <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or <br />disconnected? <br />Yes <br />No' <br />N/A <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or <br />fails a test? <br />❑ Yes <br />No" <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />® NIA <br />Yes <br />No" <br />Were all items on the equipment manufacturers maintenance checklist completed? <br />" In the Section H, below, describe how and when these deficiencies were or will he cor.P tad <br />H. Comments: <br />Completed Line Leak Detector Test, All Leak Detectors Passed. <br />Completed Spill Bucket Test. Found T1 Super Water Level Dropping. Replaced Fill Cap and Tightened Drain Valve Bolts. <br />Retest and found passed. <br />Completed Fail Safe, Positive Shutdown, and Sensor Out. All Passed <br />Tested all Bravo Float and Chain Assemblies. Tested all Impact valve operation. All Passed <br />Monitoring System Certification Page 3 of 4 12!07 <br />3 <br />2/21/07 <br />