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Monitoring System Certification F. In-Tank Cauging / SIR Equipment: ® Check this box iftank gauging is used only fir inventory control. ❑ Check this box if no tank gauging or SIR equipment is installed. I his section must he completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: ❑ Yes ❑ No* Has all input wiring been inspected for proper entre and termination, including testing for ground faults' ❑ Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup') ❑ Yes ❑ No* Was accuracy of system product level readings tested? ❑ Yes ❑ No* Was accuracy of system water level readings tested? ❑ Yes ❑ NO Were all probes reinstalled properly.? ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed'' * In the Section H, below,describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): ❑ Check this box if L.I.Ds are not installed. Complete the following checklist: ® yes ❑ No* For equipment start-up or annual equipment certification. was a leak simulated to verify I.LD performance" ❑ N.A Whec•k all that applrt Simulated leak rate: ® 3 g.p.h.. [10.1 u.p.h : [10.2 g..p.h. ® Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements`' ® Yes ❑ No* \k as the testing,apparatus properly calibrated`' ❑ Yes ❑ No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak' ® NSA ® Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if the L.t_.D detects a leak? ❑ N,A ® Yes ❑ No* For electronic LL.Ds, does the turbine automatically shut off if any portion of the monitoring system is disabled ❑ N-A or disconnected" ® Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions ❑ N:A or fails a test? Q Yes ❑ No* For electronic LLDs. have all accessible wiring connections been visually inspected? ❑ N/A ® Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed" * In the Section H, below,describe how and when these deficiencies were or will be corrected. H. Comments: - -.-- --- ------ ----- ---- — P:q;e 3 of 3