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F. in -Tank Gauging / SIR Equipment: Check this box if tank gauging is used on <br />❑ Check this box if no tank gauging or SIR <br />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. <br />Complete the following checklist: <br />my forRW,2EIVED <br />equip e <br />Yes <br />b—N—o*--- <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check aff that apply) <br />Has all input wiling 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? HEALTH D <br />Yes <br />❑ <br />No* <br />Was accuracy of system product level readings tested? <br />Yes <br />❑ <br />No* <br />Was accuracy of system water level readings tested? <br />Yes <br />❑ <br />No' <br />were all probes reinstalled properly? <br />Yes <br />[]--No* <br />❑ N/A <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />13 Yes <br />h- 4h—. —ra nr will ho rnrrpc-tpd <br />Line Leak Detectors (LLD): <br />[I Check this box if LLDs are not installed. <br />❑ Yes <br />❑ No* <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check aff that apply) <br />N/A <br />Simulated leak rate: [13 g.p.h.; [3 0.1 g.p.h ; [10.2 g.p.h. <br />13 Yes <br />❑ No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />0 Yes <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />0 Yes <br />❑ No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />❑ NIA <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />❑ N/A <br />13 Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br />0 N/A <br />13 Yes <br />El No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? <br />[I N/A <br />❑ Yes <br />0 No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />[I N/A <br />0 Yes <br />El No* <br />Were all items on the equipment manufacturers maintenance checklist completed? <br />Wri�=-ji ' .1111171 - - - — . ;; . w ; — --- <br />H. comments: WAS UNABLE TO TEST PLLD BECAUSE OF THE VEEDER ROOT PROBLEMS <br />01 <br />Monitoring System Certification Page 3 of 4 2/21/07 <br />