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w.tou0cri.ng System Certification <br />Site Address:Oate of'festing/Servicing: 8 <br />F. In -Tank Gauging / 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 />ffC3No* <br />* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />No Were all tank gauging probes visually inspected for damage and residue buildup? <br />* Was accuracy of system product level readings tested? <br />* Was accuracy of system water level readings tested? <br />* Were all probes reinstalled properly? <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In the Section H, below, describe how and when these delicieneics were or will be corrected. <br />G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />Com tete the following checklist: <br />Yes ❑ No* For equipment start-up or annual equipment cWtification, was a leak simulated to verify LLD performance? <br />❑ N/A (Check all that apply) Simulated leak rate: 3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h.` <br />❑ Yes 113 No* I Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Yes ❑ No* Was the testing apparatus properly calibrated? <br />Ed <br />Yes ❑ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />❑ N/A <br />13 Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />N/A <br />❑ Yes ❑ Alo* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />N/A or disconnected? <br />4YesObio* For electronic LLDs, does the turbineautomaticallyshut off if any portion of the m <br />N/A malfunctions or fails a test? <br />0* For electronic LLDs, have all accessible wiring connections been visually inspected? <br />N/A <br />Ef Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br />4 In the Section H, below, describe how and when these deficiencies were or will be corrected. <br />I. Comments: <br />system <br />