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F. in -Tank Gauging I 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 />4UI11 ICLC <br />X Yes <br />L11G IVI[V� <br />U No` <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />X <br />Yes <br />!_ No` <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />X <br />Yes <br />i Ido' <br />Was accuracy of system product level readings tested? <br />X <br />Yes <br />No' <br />Was accuracy of system water level readings tested? <br />X <br />Yes <br />No' <br />Were all probes reinstalled properly? <br />X <br />YesNo' <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />' in the Section H, below, describe how and when these aeticiencies were or wm De correccea. <br />G. Line Leak Detectors (LLD): (X) Check this box if LLDs are not installed. <br />X Yes <br />No' <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all <br />_ NIA <br />that apply) Simulated leak rate: X 3 g.p.h.; 0.1 g.p.h ;_ 0.2 g.p.h. <br />X Yes <br />No' <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />X Yes <br />ll <br />Was the testing apparatus properly calibrated? <br />Yes <br />No' <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />X NIA <br />X Yes <br />i No' <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />NIA <br />X Yes <br />No' <br />For electronic Lll does the turbine automatically shut off if any portion of the monitoring system is disabled or <br />NIA <br />disconnected? <br />X Yes <br />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 />X Yes <br />No' <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />NIA <br />X Yes <br />No' <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />" In the Section h, Detow, GescriDe now ana when [nese UU Lltl1141oa W.I. V+ —,,, MG - <br />H. Comments: <br />3129/2017 Inspection completed with EHD to clear all violations. Tested PLLD, verlfied sensor out and fail safe. Performed lake test <br />on all spill buckets — all passed. <br />IVE <br />Monitoring System Certification Page 3 ofd [)7 <br />JAN 2 4 2018 <br />3 ENVIRONMENTAL HEALTH 2/21/07 <br />DEPARTMENT <br />