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Oct P9 10 12:08p Elite TV Contactors 12094616342 p.5 <br />F. in -Tank Gauging / SIR Equipment: D Check this box if tank gauging is used only for inventory control. <br />O 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 _-1 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 />q Yes _ No' Was accuracy of system product level readings tested? <br />v Yes C NO, Was accuracy of system water level readings tested? <br />O Yes C No` Were all probes reinstalled properly? <br />O Yes ❑ No' Were all items on the equipment manufacturer's maintenance checklist completed? <br />In the Section H, below, describe how and when these deficiencies were or will be corrected. <br />G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />Complete the <br />following checklist: <br />O No' <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check al! <br />Yes <br />O N/A <br />that apply) Simulated leak rate: P g.p.h; = 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />Fr Yes <br />O No' <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Yes <br />❑ No" <br />Was the testing apparatus properly calibrated? <br />G Yes <br />O No' <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />G:% Yes <br />f:3? NIA <br />O No' <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />OF Yes <br />❑ NIA <br />❑ No` <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or <br />❑ N/A <br />disconnected? <br />Yes <br />D No' <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or <br />O N/A <br />fails a test? <br />Yes <br />❑ No' <br />For electronic LLDs, have ail accessible wiring connections been visually inspected? <br />❑ N/A <br />l Yes <br />❑ No' <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />' In the Section H, below, descnoe now ana wnen mesa ue„c c, w�, Q .-- -••-• I --- <br />H. Comments; <br />Monitoring System Certification Page 3 of 4 <br />12107 <br />3 2/21/07 <br />