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PIRM <br /> 61 m FR-RYA Af INC. GR Job# 20-630005 <br /> F. In-Tank Gauging!SIR Equipment: G 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 /> G Yes ❑ o Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> Ej Yes ❑ No' Were all tank gauging probes visually inspected for damage and residue buildup? <br /> ji 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 /> Yes [, No` Were all items on the equipment manufacturers maintenance checklist compleled? <br /> In the Section H,below,describe how and en these deficiencies 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 it7 0 or equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance check all <br /> ❑ WA that apply) Simulated leak rate: ❑ 3 g.p.h. ❑ 0.1 g p.h. ❑ 0.2 g.p.h. <br /> Ia Yes ❑ No' Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> Yes ❑ No' Was the testing apparatus property calibrated? <br /> ❑ Yes 17 No' For Mechanical LLDs,does the LLD restrict product flow If it detects a leak? <br /> Ij NIA <br /> Yes ❑ No' For electronic LLDs,does the turbine automatically shut off tf the LLD detects a leak? <br /> ❑ NIA <br /> [j Yes ❑ No- For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled or <br /> ❑ NIA Disconnected? <br /> Yes ❑ No' For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctlors or <br /> ❑ N1A fails a test? <br /> Yes ❑ No' For electronic LLDs,have all accessible wiring connections been visually inspected <br /> 13 N/A <br /> I& Yes ❑ No' 1were all items on the equipment manufacturer's maintenance checklist completed? <br /> In the Section H,below,describe how and when these deficlencles were or w111 a corrocted. <br /> G. Comments: <br /> Monitoring System Certification Page 3 of 4 12107 <br /> 3 <br />