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F. In-Tank Gauging 1 SIR Equipment: X Check this box if tank gauging is used only for inventory control. U Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: Yes u No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? Yes a No* Were all tank gauging probes visually inspected for damage and residue buildup? Yes [:i No* Was accuracy of system product level readings tested? Yes ❑ No* Was accuracy of system water level readings tested? Yes ❑ No* Were all probes reinstalled properly? Yes a No* Were all items on the equipment manufacturer's maintenance checklist completed? In the Section H,below,describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors(LLD): (X)Check this box if LLDs are not installed. Complete the followring checklist: Yes n No* For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance?(Check all 0 N/A that apply) Simulated leak rate: ❑3 g.p.h.; ❑0.1 g.p.h; u 0.2 g.p.h. Yes a No* Were all LLDs confirmed operational and accurate within regulatory requirements? Yes n No* Was the testing apparatus properly calibrated? Yes n No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? u N/A Yes 0 No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? N/A Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or N/A disconnected? Yes in No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctionsor N/A fails a test? Yes ❑ No* For electronic LLDs,have all accessible wiring connections been visually inspected? n N/A Yes 0 No* Were all items on the equipment manufacturers maintenance checklist completed? *In the Section H,Flow,describe how and when these deficiencies were or velli be corrected. H. Comments: SAFE SUCTION SYSTEM Nny 1 2016 y► N MT AL w eve, EPA Monitoring System Certification Page 3 of 4 12107 3 2/21/07