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0 0 <br /> F. In Tank Gauging I SIR Equipment: ri Check this box if tank gauging is used only for inventory control. <br /> 0 Check this box if no tank gauging or SIR equipment is installed. <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. <br /> Complete the following checklist: <br /> x Yes Ei No* Has all input wiring been inspefor proper entry and termination,including testing for ground faults? <br /> ❑ Yes x No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> 0 Yes x No* Was accuracy of system product level readings tested? <br /> El Yes x No* Was accuracy of system water level readings tested? <br /> cl Yes x No* Were all probes reinstalled properly? <br /> x Yes 0 No- Were all items on the equipment manufacturer's maintenance checklist completed? <br /> *In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> G. Line Leak Detectors(LLD): u Check this box if LLDs are not installed. <br /> Complete the following c ldist:- <br /> • Yes I c No* For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance?(Check all <br /> Ei N/A that apply) Simulated leak rate: x 3 g.p.h.; 0 0.1 g.p.h; 0 0.2 g.p.h. <br /> • Yes 11 No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> • Yes El No* Was the testing apparatus properly calibrated? <br /> x Yes -j No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> [I NIA <br /> 0 Yes El No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> x N/A <br /> C, Yes ca No* For electronic LLDs, does the turbine automatically shut off d any portion of the monitoring system is disabled or <br /> x N/A disconnected? <br /> "I Yes 0 No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions or <br /> x WA fails a test? <br /> EJ Yes j Ne For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> x NIA I <br /> x Yes-- 0 No* I Were all items on the equipment manufacturer's maintenance checklist completed? <br /> *In S on H, low,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: See leak detector form. <br /> Monitoring System Cert1fication Page 3 of 4 12fOT <br /> 3 2/21/07 <br />