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tutoring System Certification <br /> Date of Testing/Servicing: <br /> Address: <br /> 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 /> is section must be completed if il�_tank gauging equipment is used to perform leak detection monitoring. <br /> replete the (lowing checklist- <br /> Ya Nb* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> WS 01440* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> Yes o* Was accuracy of system product level readings tested? <br /> y No* Was accuracy of system water level readings tested? <br /> Yes C1o* Were all probes reinstalled properly? <br /> Yes No« Wereall items.on the equipment manufacturer's maintenance checklist completed? <br /> n the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> Line Leak Detectors(LLD): ❑ Check this box if LLDs are not installed. <br /> mpletathefollawing checklist: <br /> es. . ❑ No* - For:equipment.start-up or annual equipment certification, was a leak s' ted t z verify LLD performance? <br /> ❑ N/A (Check all that aPP1YJ Simulated leak rate: ❑3 g.p h.; ❑0.19.1) ; 02 g.p h. <br /> Notes: I. Required for equipment start-up certification and annual certification. <br /> 2..Unless mandated by local certificationagency,' required only for electronic LLD start-up. <br /> ❑ No* . Were all LLDs confirmed operational and accurate within regulatory requir meats? <br /> ❑ No* Was the testing apparatus properly calibrated? <br /> Yes ❑ No* For mechanical LLDs;does the LLD restrict product now if it detects a leak? <br /> ❑ N/A - <br /> ❑ N®* For electronic LLDS'does the turbine automatically shut off if the LLD detects a leak? <br /> 61/A <br /> Yes ❑ � For-electronic-LLDs;does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> N/A or disconnected? <br /> Yes ❑ o* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system <br /> malfunctions or fails a test? <br /> Yes ❑ o* For electronic.LLDs,have all accessible wiring connections been visually inspected? <br /> A <br /> 1' Yes No*' Were all items on the equipment manufacturer's maintenance checklist completed? <br /> en these deficiencies were or will be corrected. <br /> In the Section H,below,describe how and wh <br /> L Comments: <br />