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Nov 18 , 09 10:36a <br />Monitoring System Certification <br />209-367-5424 <br />F. In -Tank Gauging 1 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 />This section trust be completed if in -tank gauging equipment is used to perform leak detection monitoring. <br />Complete the followingchecklist: <br />I <br />Yes' <br />❑ NO <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />Yes <br />❑ No* <br />Were all tank gauging probes visually inspected for damage and residue ,buildup? <br />CK Yes <br />❑ No* <br />Was accuracy of system product level readings tested? <br />P Yes <br />❑ No* <br />Was accuracy of system water level readings tested? <br />PK Yes <br />❑ No* <br />Were all probes reinstalled properly? <br />1% Yes <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 />G. Line Leak Detectors (LLD): <br />❑ Check this box if LLDs are not installed. <br />vVAA <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br />(Check all that apply) Simulated leak rate: ❑ 3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />❑ Yes <br />❑ No* <br />g� N/A <br />❑ Yes <br />❑ No* <br />Were all LLDs confirmed operational and accurateiwithin regulatory requirements? <br />❑ Yes <br />® No* <br />Was the testing apparatus properly calibrated? <br />Yes <br />❑ No* <br />❑ NIA <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />❑ Yes <br />Q No* <br />IR N/A <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />❑ Yes <br />❑ No* <br />NIA <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />or, disconnected? <br />❑ Yes <br />❑ No* <br />NIA <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system <br />malfunctions or fails a test? <br />❑ Yes <br />❑ No* <br />® NIA <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />I@ Yes <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In Section H, below, describe bow and when these deficiencies were or will be corrected. <br />H. Comments: <br />UN -036 — 314 <br />Page 3 of 4 <br />www.vnidoes.org <br />Rev. 01/17/08 <br />