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F. In -Tank Gauging / SIR Equipment: ❑ 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 />❑ Yes ❑ No' Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />❑ Yes ❑ No" Were all tank gauging probes visually inspected for damage and residue buildup? <br />❑ Yes ❑ No' Was accuracy of system—product 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 manufacturer's maintenance checklist completed? <br />In Section H, below, describe how and when these deficiencies were or will be corrected. <br />Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed <br />' In Section H, below, describe how and when these deficiencies were or will be corrected <br />Comments <br />Monitoring System Certification Page 3 of 4 2/21/07 <br />Complete the following <br />checklist: <br />No' <br />N/A <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Checkall that apply) <br />Simulated leak rate: ® 3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />No' <br />Were all LLDs confirrned operationaland accurate within regulatory requirements? <br />No' <br />Was the testing apparatus properly calibrated? <br />%YesEl <br />No' <br />N/ANo' <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />N/ANo' <br />For electronic LLDs, doesthe turbine automatically shut off if the LLD detects a leak? <br />N/ANo' <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br />® <br />N/A <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? <br />O <br />Yes <br />❑ <br />® <br />No' <br />N/A <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />® <br />Yes <br />❑ <br />No' <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />' In Section H, below, describe how and when these deficiencies were or will be corrected <br />Comments <br />Monitoring System Certification Page 3 of 4 2/21/07 <br />