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F. In-Tank Gauging/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 /> Complete the followin checklist: <br /> Ll Yes ❑ No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> 1 Yes I.J No' Were all tank gauging probes visually inspected for damage and residue buildup <br /> -1 Yes I No' Was accuracy of system product level readings tested? <br /> :7 Yes 7. No' Was accuracy of system water level readings tested? <br /> I Yes n No' Were all probes reinstalled property? <br /> n Yes n No' Were all Nems on the equipment manufacturer's maintenance checklist completed? MAY 12 9911 <br /> In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> G Line Leak Detectors (LLD): I ; Check this box if LLDs are not installed. ENVIRONMENTAL HEALTH <br /> "­�r 'RENT <br /> Complete the following checklist: <br /> X Yes ❑ No* For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance? (Check all <br /> 11 N/A that apply) Simulated leak rate: X 3 g.p.h.; 10.1 g.p.h ❑0.2 g.p.h. <br /> X Yes fj No' Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> X Yes No' Was the testing apparatus properly calibrated? <br /> X Yes J No' For mechanical LLDs,does the LLD restrict product flow if N detects a leak? <br /> N/A <br /> ❑ Yes C No' For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> X N/A <br /> ❑ Yes n No` For electronic LLDs, does the turbine automatically shut off'rf any portion of the monitoring system is disabled or <br /> X N/A disconnected? <br /> ❑ Yes ❑ No` For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails <br /> X N/A a test? <br /> ❑ Yes ❑ No' For electronic LLDs, have all accessible wiring connections been visually inspected? <br /> X N/A <br /> X Yes ❑ No` Were all Nems on the equipment manufacturer's maintenance checklist completed? <br /> •In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: 91 #2 LLD WAS REPLACED <br /> I. <br /> Monitoring System Certification Page 3 of 4 17107 <br /> 3 2/21/07 <br />