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GfTTI ER -RYAN lac. GR Job # 1720- 4947 <br />SWRCB, January 2006 <br />--- <br />F. In -Tank Gauging I SIR Equipment: 13—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 fin -tank gauging equipment is used to perform leak detection monitoring. <br />COMMIRbi Me fellnW nn rhurklint' <br />Id <br />she <br />❑ <br />o <br />Has all input wing been inspected for proper entry and termination, including testing for ground faults? <br />m <br />Yes <br />❑ <br />No' <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />• <br />Yes <br />❑ <br />No' <br />Was accuracy of system products level readings tested? <br />m <br />Yes <br />❑ <br />No' <br />Was accuracy of system water level readings tested? <br />❑ <br />Yes <br />❑ <br />No' <br />Were all probes reinstalled properly? <br />EI <br />n <br />Yes ❑ <br />s we nn <br />No' <br />_ nW <br />Were all items on the equipment manufacturers maintenance checklist completed? <br />G. Line Leak Detectors (LLD): m Check this box if LLDs are not installed. <br />complete the followtna checklist <br />❑ <br />as <br />❑ <br />o <br />or equipment sum -up or annual egurpmen ce ca on, was a leak simulated to Vennt LLU pa mance (check Bit <br />❑ <br />wA <br />that apply) Simulated leak rate: [] 3 g.p.h. ❑ 0.1 up h. [] 0.2 g.on <br />❑ <br />Yes <br />❑ <br />No' <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />❑ <br />Yes <br />❑ <br />No' <br />Was the testing apparatus property calibrated? <br />❑ <br />Yes <br />❑ <br />No' <br />For Mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />❑ <br />N/A <br />❑ <br />Yes <br />❑ <br />No' <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />"[T <br />❑ <br />N/A <br />Yes <br />❑ <br />No' <br />For electronic LLDs, does the turbine automatically shut ort 0 any portion of the monitoring system is disabled or <br />❑ <br />N/A <br />Disconnected? <br />❑ <br />Veer <br />❑ <br />No' <br />For electronic LLDs, does the lumina automatically shut off 0 any portion of the monitoring system malfunctions or <br />❑ <br />N/A Ifails <br />a test? <br />❑ <br />Yes <br />❑ <br />No' <br />For electronic Ds, have all accessible wiring connections been visually inspected? <br />❑ <br />N/A <br />❑ Yes 1 <br />❑ <br />No' 1were <br />all Hems on the equipment manufacturers maintenance checklist completed? <br />G. <br />LD's , a suction site. <br />Monitoring System Certlecatlon Page 1 of 4 12107 <br />3 <br />