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UNDERGROU_ STORLGE TANK MONITORLNG SYSTEJ. LRTIFICATIOlti F. In-Tanh Gauging / SIR Equipment: Permit Number: ❑ Check this box_ if tank gauging is used only for inventory control ❑ Check tais box if no tank mu-_= o_ SIP, equipment is installed This section must be completed if in-taiah gauging equipment is used to perform leak detection monitorinc,. rmmnlafP fhe fnlinwino checklist: Cl Yes ❑ _ * Has all input wiring been inspected for proper entry and termination, including testing for ground faults ❑ Yes ❑ No* W ere all tank gauging probes visually inspected for damage and residue buildup? 11 ❑ Yes I ❑ .No* I INaccuracy of system product level readings tested? ❑ Yes ❑ No Was a uracy of system water level readings tested? ❑ Yes ❑ No* Were all ppbes reinstalled properly?=' ❑ Yes ❑ No* Were all itriN on the equipment manufacturer's mainten7 e checklist completed? * In Section H below, describe hog d when these deficiencies were yVwill be corrected. G. Line Leak Detectors (LLD): ❑ Check this box if s are not installed. Complete the following checklist: ❑ Yes ❑ No* pment certincation, was a leak simulated to verify LLD performance'?❑ For equipment start-up orVdIe N/A (Check all that apply) Simate: ❑ 3 g.p.h.; ❑ 0.1 g.p.h ; . ❑ 0.2 g.p.h. ❑ Yes ❑ No* Were all LLDs confirmed ope tion and accurate within regulatory requirements? ❑ Yes ❑ No* Was the testing apparatus pp6perly tali ted? ❑ Yes ❑ No* For mechanical LLDs, d s. the LLD res tri roduct flow if it detects a leak? ❑ NIA ❑ Yes ❑ No* For electronic LLD,, does .the turbine automatic y shut off if the LLD detects a leak? ❑ NIA f _. ❑ Yes ❑ No* For electronic L/LDs, does the turbine automatically t off if any portion of the monitoring. system is disabled ❑ NIA or disconnected? ❑ 'Yes ❑ No* For electronic LLDs, does the turbine automatically shut off any portion of the monitoring system malfunctions ❑ NIA or fails a test? ❑ Yes ❑ No* For electronic LLDs, have all accessible wiring connections been ' uallyinspected? ❑ NIA ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist compldted? * In Section H below,-describe:hovi, and when these deficiencies were or will be corrected. 11. Comments: DEH:HM.93o1,(IteV 08/02). ;' :: Page 3 of 4 County of San Diego -DEH -Hazardous Materials Division,