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�GErri:ER-RYAN INc. GR Job # kAE r. V E <br /> F. In-Tank Gauging/SIR Equipment: ❑ Check this box if tank gauging is used only for inventory control, i\� 1 1 2016 <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 /> f4r7A;-ru r1177r.A0T1A7K17- <br /> Complete the following checklist: <br /> Yes ❑ o Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> IE Yes ❑ No' Were all tank gauging probes visually inspected for damage and residue buildup? <br /> E Yes ❑ No' Was accuracy of system products level readings tested? <br /> Yes ❑ No' Was accuracy of system water level readings tested? <br /> Yes ❑ No' Were all probes reinstalled properly? <br /> 11 Yes I ❑ No' 1were all items on the equipment manufacturer's maintenance checklist completed? <br /> 'Int the Section H,below,describe how and when these e c enc es were or will be corrected. <br /> G. Line Leak Detectors(LLD): ❑ Check this box if LLDs are not installed. <br /> Complete the following checklist: <br /> Yes ❑ o or equipment start-up or annual equipment certification,was a leak simulated to verity LLD pe ormance (check all <br /> ❑ NIA that apply) 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 if it detects a leak? <br /> NIA <br /> Yes ❑ No' For electronic LLDs,does the turbine automatically shut off it 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 <br /> ❑ N/A Disconnected? <br /> Id Yes ❑ No' For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions or <br /> ❑ N/A tails a test? <br /> 11 Yes ❑ No' For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> ❑ NIA <br /> ry Yes ❑ No' were all items on the equipment manufacturer's maintenance checklist completed? <br /> In the Section H,below,describe ow and when these deficiencies were or will be corrected. <br /> G. Comments: <br /> Monitoring System Certification Page 3 of 4 12/07 <br /> 3 <br />