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1 <br /> F. In-Tank Gauging/SIR Equipment: ❑Check this box if tank gauging is used only for inventory contr <br /> 1. <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 /> ® Yes ❑ No* Has all input wiring been inspected for proper entry and termination, including testing for ground f ults? <br /> ® Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> ®Yes ElNo* Was accuracy of system product level readings tested? riaOE <br /> ®Yes ❑ No* Was accuracy of system water level readings tested? <br /> ®Yes ❑ No* Were all probes reinstalled properly? -v <br /> ®Yes ❑ No Were all items on thel equipment manufacturer's maintenance checklist completed? ENVIRUNMENTA <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 /> Com lets the foliowin checklist: <br /> ® Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance <br /> ❑ N/A (Check all that apply)', Simulated leak rate: 03 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 syste is disabled <br /> ® N/A or disconnected? <br /> ❑ Yes ❑ No* For electronic LLDs does the turbine automatically shut off if any portion of the monito ing system <br /> ® N/A malfunctions or fails attest? <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 /> I <br /> H. Comments: <br /> I <br /> i <br /> i <br /> I <br /> li �I <br /> i <br /> i <br /> Monitoring Certification Test Report <br /> 13 of <br />