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0 1 * <br />F. In -Tank Garaging f SIR Equipment; ® 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 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 />Yes El No' Was accuracy of system product level readings tested? <br />Yes Ne Was accuracy of system water level readings tested? <br />Yes No' Were all probes reinstalled property? <br />Yes Lj No' 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 be corrected. <br />G. Line Leak Detectors (LLD):Mechanical ❑ Check this box if LLDs are not installed. <br />Qorn wage [ne <br />❑ Yes <br />Yes <br />Yes <br />Tonowin cnecRnsA: <br />No' <br />[] NIA <br />No' <br />No' <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all <br />that apply) Simulated leak rate: R 3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Was the testing apparatus properly calibrated? <br />Yes <br />Na' <br />For mechanical LLDs, does the LLD restrict product flow it it detects a leak? <br />NIA <br />Yes <br />No' <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />El Yes <br />❑ NIA <br />El No' <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or <br />® NIA <br />disconnected? <br />Yes <br />77 No" <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or <br />® NIA <br />fails a test? <br />Yes <br />No' <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />N/A <br />77 Yes <br />No' <br />Were all items on the equipment manufacturers maintenance checklist completed? <br />-in u w aecuon n, Lmww, <br />H. Comments: <br />Mechanical LLDs were not tested. Site required partial Monitor Certification due to system cold start. Tested Veeder 'Root <br />sensors, fail safe, & positive shutdown. <br />Monitoring system Certilicatlon Page 3 of 4 <br />12107 <br />3 2121107 <br />