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• <br />• <br />F. In -Tank Gauging 1 SIR Equipment: X 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 />Comolete the fnllm inn rharklict- <br />❑ Yes <br />J No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />❑ Yes <br />ri No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />❑ Yes <br />❑ No* <br />Was accuracy of system product level readings tested? <br />U Yes <br />Ll No* <br />Was accuracy of system water level readings tested? <br />❑ Yes <br />Q No* <br />Were all probes reinstalled properly? <br />❑ Yes ❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />_.._ ____. _...., __..,.... ..........vv ..v.. u ... 1— ii .— vclrc ...a...0 _GIQ Idl will VC l.VI I WGUM. <br />G. Line Leak Detectors (LLD): r Check this box if LLDs are not installed. <br />Cnrnnlata thw fnnnsuinn rtrnr4lict <br />X Yes <br />❑ No* <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD (Check <br />❑ NIA <br />performance? all <br />that apply) Simulated leak rate: X 3 g.p.h.; ❑ 0.1 g.p.h ; 1:10.2 g,p.h. <br />X Yes <br />❑ No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />X Yes <br />F No* <br />Was the testing apparatus properly calibrated? <br />X Yes <br />❑ No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />Ci NIA <br />i- Yes <br />I_; No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />X NIA <br />❑ Yes <br />l No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or <br />X NIA <br />disconnected? <br />El Yes <br />i No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails <br />X NIA <br />a test? <br />❑ Yes <br />No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />X NIA <br />X Yes <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />.1. - •+— -1. , ­, ua rluc lluw arlu rrntfll Mese aenum"cies were or wnl oe correcte0. <br />H. Comments: <br />Monitoring System Certification Page 3 of 4 12107 <br />2/21/07 <br />