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9255517888 Line 11:03:05 07-28-2014 4/8 <br /> GET TL ER-RYAN INC. GR Job# 20-601679 <br /> F. In-Tank Gauging/SIR Equipment: Cx 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-lank gauging equipment is used to perform leak detection monitoring. <br /> Complete the following checklist: RECEIVED <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 products level readings tested? <br /> ❑ Yes ❑ No` Was accuracy of system water level readings tested?Yes ❑ No' Were all probes reinstalled properly? �LTH <br /> 11 ❑ Yes I ❑ No' lWere 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 following checklist: <br /> ❑ es ❑ o For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance?(check all <br /> [x N/A that apply) Simulated leak rale: ❑ 3 g.p.h. ❑ 0.1 g.p.h. ❑ 0.2 g.p.h. <br /> ❑ 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 /> 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 /> N/A 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 /> ❑ 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. Comments: <br /> Only Test L10 Sensor <br /> Monitoring System Certification Page 3 of 4 12107 <br /> 3 <br /> Received Time Jul. 28, 2014 10: 51AM No, 6694 <br />