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. w MJL _ F. M-Tank Gauging/SIR Equipment: ❑ Check 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 gro Mn ❑ Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? 1 IV Lm 9 ;. ❑ Yes ❑ No* Was accuracy of system product level readings tested? ❑ Yes ❑ No* Was accuracy of system water level readings tested? ) _F 7 U I f ❑ Yes ❑ No* Were all probes reinstalled properly? ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? ENVIRONMENTAL In Section H,below,describe how and when these deficiencies were or will be corrected. M ENT Line Leak Detectors(LLD): ❑ Check this box if LLDs are not installed. Complete the following checklist: ® Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) ❑ N/A Simulated leak rate: ®3 g.p.h.; ❑0.1 g.p.h; ❑0.2 g.p.h. ® Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? ® Yes ❑ No* Was the testing apparatus properly calibrated? ® Yes ❑ No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? ❑ N/A ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? ® N/A ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? ® N/A ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? ® N/A ❑ Yes ❑ No* For electronic LLDs,have all accessible wiring connections been visually inspected? ® N/A ® Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? *In Section H,below,describe how and when these deficiencies were or will be corrected. H. .Comments: ADJUSTED 87 LEAK DETECTOR Monitoring System Certification Page 3 of 4 2/21/07