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1.1//.u`J/Lulu rVL1 lu:4y rAX Lu`J4bbj4ZJ bJU ZHU -'-'- AXZOraa1Mest W11v4/uv/ <br />1 <br />F. in -Tank Gauging 1 SIR Equipment: ® Check this box if tank gauging is used only for inventory control. <br />D Check this box if no tank gauging or SIR equipment is installed. <br />This section must W completed if in -tank gauging equipment is used to perform leak detection monitoring. <br />Complete the following checklist: <br />O 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 />❑ Yes <br />❑ <br />No' <br />Was accuracy of system product level readings tested? <br />D Yes <br />0 <br />No' <br />Was accuracy of system water level readings tested? <br />❑ Yes <br />O <br />No' <br />I Were all probes reinstalled properly? <br />❑ Yes <br />1 ❑ <br />No' <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />' In Section H, below, describe how and when these deficlencies were or will be corrected. <br />Line Leak Detectors (LLD): ❑ Check this box if LLDs are riot installed. <br />f�nn.nt..tn hhn rollnu.:nn wf�nn4t:�l� <br />® Yes <br />❑ <br />No' <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? JCheck ap fbar apply) <br />® <br />N/A <br />Simulated leak rate: ® 3 ".h.; 0 0.9 g.p.h ; ❑ 0.2 g.p.h. <br />0 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 properly calibrated? <br />0 Yes <br />❑ <br />No' <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />❑ <br />N/A <br />❑ Yes <br />D <br />No' <br />For electronic LL Ds, does the turbine automatically shut off if the LLD detects a leak? <br />0 <br />WA <br />• Yes <br />❑ <br />No' <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br />® <br />NlA <br />❑ Yes <br />O <br />No. <br />For electronic LLDs, does the turbine autornatiraliy shut off if any portion of the monitoring system malfunctions or fails a test? <br />63I <br />NIA <br />❑ Yes <br />❑ <br />No, <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />® <br />N/A <br />Yes <br />❑ <br />No. <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />in section ti, oetow, d®scrioe now ano wnen mese aercciencies were or will oe correcteo. <br />H. Comments <br />Monitoring System Certification Page 3 of 4 2/2 M7 <br />L000/%0000] XHd V£:OT OTOZ/£T/LO <br />