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r RECEIVED <br /> F. In-Tank Gauging I SIR Equipment: ❑ Check this box if tank gauging is used only for inventory 1. <br /> ® Check this box if no tank gauging or SIR equipment is irfdtWldd.2 2 2013 <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. ENV[R <br /> TALComplete the following checklist: �, <br /> El Yes ❑ No' Has all input wiring been inspected for proper entry and temninalion,including testing for ground faults? Nr <br /> ❑ Yes ❑ No' Were all tank gauging probes visually inspected for damage and residue buildup? <br /> ❑ Yes ❑ No' Was accuracy of system product level readings tested? <br /> ❑ Yes ❑ No' Was accuracy of system water level readings tested? <br /> ❑ Yes ❑ No' Were all probes reinstalled properly? <br /> ❑ Yes ❑ No' Were all items on the equipment manufacturers maintenance checklist completed? <br /> In Section H,below,describe how and when these deficiencies were or will be corrected. <br /> Line Leak Detectors(LLD): ® Check this box if LLDs are not installed. <br /> Complete the following checklist: <br /> ❑ Yes ❑ No' For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) <br /> ❑ N/A Simulated leak rate: ❑3 g.p.h,; ❑0.1 g.p.h; ❑0.2 g.p.h. <br /> ❑ Yes ❑ No' Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> ❑ Yes ❑ No' Was the testing apparatus properly calibrated? <br /> ❑ Yes ❑ No' For mechanical LLDs,does the LLD restrict product flow g it detects a leak? <br /> ❑ N/A <br /> ❑ Yes ❑ No' For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> ❑ NIA <br /> ❑ Yes ❑ No' For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br /> ❑ N/A <br /> ❑ Yes ❑ No' For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? <br /> ❑ NIA <br /> ❑ Yes ❑ No' For electronic LLDs,have all accessible win ng connections been visually inspected? <br /> El NA <br /> ❑ Yes ❑ No' Were all items on the equipment manufacturer's maintenance checklist completed? <br /> In Section H,beow <br /> l ,tlescribe MMM when these deficiencies were or will be corrected. <br /> H. Comments: <br /> Monitoring System Certification page 3 of 4 2/21/07 <br />