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Monilcri.ng System Certification Site Address: • •e of Testi n-/Servicing: F. In-Tank Gauging/ SIR Equipment: heck this box if tank gauging is used only for inventory control. ❑ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: ❑ Yes ❑ No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? ❑ Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? ❑ Yes ❑ No* Was accuracy of system product level readings tested? ❑ Yes ❑ No* Was accuracy of system water level readings tested? ❑ Yes ❑ No* Were all probes reinstalled properly? ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. Co tete the following checklist: Yes ❑ No* For equipment start-up or annual equipment cc tification, was a leak simulated to verify LLD performance? ❑ N/A (Check all chat apply) Simulated leak rate: ll'3 g.p.h.; ❑ 0.1 g.p.h ; ❑0.2 g.p.h. es 1 ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? Yes ❑ No* Was the testing apparatus properly calibrated? zf Yes ❑ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ❑ N/A ❑ Yes ❑ * For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? 16 N/A Yes ❑ o* For electronic LLDs, does the turbine automatically shat off if any portion of the monitoring system is disabled ,6 N/A or disconnected? Yes ❑ o* For electronic LLDs, does (lie turbine automatically shut off if any portion of the monitoring system N/A malfunctions or fails a test? 7 Yes ❑ o* For electronic LLDs, have all accessible wiring connections been visually inspected? d N/A Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? In the Section H, below, describe how and when these deficiencies were or will be corrected. I. Comments: