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9255517888 Line �.10'.58 10-12-2012 5/6 <br /> �GerfLex-RYAN Inr. GR Job# 20-581987 <br /> F. In-Tank Gauging/SIR Equipment: E 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 following checklist: <br /> 'r ❑ o Has all input wiring been inspected for proper entry and lemanation.Including testing for ground faults? <br /> ❑ No' Were all tank gauging probes visually inspected for damage and residue buildup? <br /> yes ❑ No' Was accuracy of system products level readings tested? <br /> ❑ No' Was accuracy of system water level readings tested? <br /> ❑ NO' Were all probes reinstalled properly? <br /> ❑ No' Were all gems on the equipment manufacture(.maintenance checklist completed? <br /> In the ecbon H,below, esti a ow antl when t ase a Ticlencles were or will corrected. <br /> G. Line Leak Detectors(LLD): ❑ Check this box H LLDs are not installed. <br /> Complete the following checklist <br /> ry Yes ❑ o Far equipment start-up or annual equipmentcertification,was a leak simulated to verily LLD performance a alf <br /> [3N/A that app/yJ Simulated leak rate: ® 3 g.p.h. ❑ 0.1 g.p.h. ❑ 0.2 gp.h. <br /> ff Yes ❑ NO' jWere all LLDs wnffhned operational and amuratewrmin regulatory requirements? <br /> ry Yes ❑ No' lWaTthe testing apparatus property calibrated? <br /> ❑ Yes ❑ No' For Mechanical LLDs,does the LLD restrict product flow If it detects a leak? <br /> E NIA <br /> Ix Yes ❑ No' For electronic LLDs,does the turbine automatically shut off lithe LLD detects a leak? <br /> ❑ N/A <br /> r, Yes ❑ No- For electronic LLDs,does the tuOne automatically shut off g any poNan of the monitoring system is disabled or <br /> ❑ N/A Disconnected? <br /> rs Yes ❑ No' For electronic LLDs,does the turbine automatically shut off If any portion of the monitoring system malfunctions or <br /> ❑ WA falls a test? <br /> G Yes ❑ No- For electronic LLDs,have a 1accessible wiring connections been visually inspected? <br /> ❑ N/A <br /> Yes ❑ N/A were all Items on the equipment manufacturers maintenance checklist completed? <br /> n the beCtIOn H,below,describe how and when these deficiencies were or will a corrected. <br /> G. Comments: <br /> Monitoring System Certification Page 3 of a 112107 <br /> 3 <br />