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iaGirrIEN-RrAtilt INC. GR Job# 20-640102 <br /> F. In-Tank Gauging I 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 /> {E es (] o Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> E Yes ❑ No' Were all tank gauging probes visually inspected for damage and residue buildup? <br /> Yes ❑ No' Was accuracy of system products level readings tested? <br /> FL Yes ❑ No- Was accuracy of system water level readings tested? <br /> r, Yes ❑ No Were all probes reinstalled property? <br /> Yes ❑ No' Were all items on the equipment manufacturer's maintenance checklist compleled? <br /> In the Section H,below,describehow and when these de is enc es 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 /> �y es o or equipment Stan-up or annuat equipment certification,was a leak Simulated lo venry UU pe ormance ec a <br /> ❑ NIA that apply) Simulated leak rate: Q 3 g p.h ❑ 0.1 g.p.h. ❑ 0 2 g p.h. <br /> ra Yes ❑ No' Were all LLDS confirmed operational and accurate within regulatory requirements? <br /> Yes ❑ No' Was the testing apparatus properly calibrated? <br /> ❑ Yes ❑ NO- For Mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> E N/A <br /> Yes ❑ No' For electronic LLDS,does the turbine automatically shut off if the LLD detects a leak? <br /> ❑ N!A <br /> Yes ❑ No' For electronic LLDS,does the turbine automatically shut off if any portion of the monitoring system is disabled or <br /> ❑ WA Disconnected? <br /> Yes ❑ No' For electronic LLDS,does the turbine automatically shut off if any portion of the monitoring system malfunctions or <br /> (� N/A fails a test? <br /> Yes ❑ No' For electronic LLDS have all accessible wiring connections been visually inspected? <br /> ❑ N/A <br /> �y Yes <br /> [1 0: were ail items on the equipment manufacturers maintenance checklist competed? <br /> In the Section ow,describe how and when these de ciencies were or will be corrected. <br /> G. Comments: <br /> Monitoring System Certification Page 3 of 4 12107 <br /> 1 <br />