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ell, t, RECEIVED <br />F. In -Tank Gauging I SIR Equipment: Check this box if tank gauging is used only for inventory ❑ <br />Check this box if no tank gauging or SIR equipment is in 0 5 2014 <br />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. E VIR NME TAL <br />Complete the following checklist: HEALTH nEPABW NT <br />❑ Yes <br />❑ <br />No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />❑ Yes <br />❑ <br />No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />13 Yes <br />❑ <br />No* <br />Was accuracy of system product level readings tested? <br />13 Yes <br />El <br />No* <br />Was accuracy of system water level readings tested? <br />❑ Yes <br />❑ <br />No* <br />Were all probes reinstalled property? <br />[3 Yes <br />❑ <br />No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In Section H, below, describe how and when these deficiencies were or will be corrected. <br />Line Leek Detectors (LLD): [3 Check this box if LLDs are not installed. <br />13 Yes <br />[3 <br />No* <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) <br />N/A <br />Simulated leak rate: [3 3 g.p.h.; [] 0.1 g.p.h; [10.2 g.p.h. <br />❑ Yes <br />❑ <br />No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />❑ Yes <br />❑ <br />No* <br />Was the testing apparatus property calibrated? <br />❑ Yes <br />❑ <br />No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />N/A <br />❑ Yes <br />❑ <br />No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />N/A <br />0 Yes <br />0 <br />No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br />N/A <br />171 Yes <br />❑ <br />No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? <br />N/A <br />❑ YesNo- <br />❑ <br />For electronic LLDs, have all accessible Wring connections been visually inspected? <br />N/A <br />I <br />❑ Yes <br />❑ <br />No* <br />I Were all items on the equipment manufacturer's maintenance checklist completed? <br />I * In Section H, below, describe how and when these deficiencies were or will Do correctea. <br />Monitoring System Certification Page 3 of 4 2/21/07 <br />