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F. In -Tank Gauging / SIREquipment: ® Check this box if tank gauging is used only for,invbnftz c�tdl <br />9� 99 9 9 Y ry <br />❑ Check this box if no tank gauging or SIR equipment is instal ed. <br />:VE[), <br />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. APR f\ ^ n p ;( n O 2015 O15 <br />Complete the following checklist: <br />❑ <br />Yes <br />❑ <br />No' <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />❑ <br />Yes <br />❑ <br />No` <br />Were all tank gauging probes visually inspected for damage and residue buildup? ^71 7TH e <br />❑ <br />Yes <br />❑ <br />No' <br />Was accuracy of system product level readings tested? <br />❑ <br />Yes <br />❑ <br />No' <br />Was accuracy of system water level readings tested? <br />❑ <br />s <br />[INo' <br />No" <br />Were all probes reinstalled properly?�E�Iyy <br />Yes <br />❑ <br />No' <br />I 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 />Comolete the following checklist: <br />® <br />Yes <br />❑ <br />No" <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) <br />❑ <br />N/A <br />Simulated leak rate: ® 3 g.p.h.: ❑ 0.1 g.p.h ; [10.2 g.p.h. <br />® <br />Yes <br />❑ <br />No' <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />® <br />Yes <br />❑ <br />No' <br />Was the testing apparatus properly calibrated? <br />❑ <br />Yes <br />❑ <br />No" <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />® <br />N/A <br />® <br />Yes <br />❑ <br />No` <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />❑ <br />N/A <br />® <br />Yes <br />❑ <br />No" <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 />® <br />Yes <br />❑ <br />No' <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? <br />❑ <br />N/A <br />® <br />Yes <br />❑ <br />No' <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />❑ <br />N/A <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 />H. Comments: <br />TAL <br />'r� �T <br />Monitoring System Certification Page 3 of 4 2/21/07 <br />