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Monitoring System Certification F. In-Tank Gauging/SIR Equipment: 0 Check this box if tank gauging is used only for inventory control. ❑ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: ❑ Yes ❑ No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? ❑ Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? ❑ Yes ❑ No* Was accuracy of system product level readings tested? ❑ Yes ❑ No* Was accuracy of system water level readings tested? ❑ Yes 1 ❑ No* I Were all probes reinstalled properly? ❑ Yes 1 ❑ No* I Were all items on the equipment manufacturer's maintenance checklist completed? *In the Section H,below,describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. Complete the following checklist: N Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? ❑ N/A (Check all that apply) Simulated leak rate: 0 3 g.p.h.; ❑0.1 g.p.h; ❑0.2 g.p.h. Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? Yes ❑ No* Was the testing apparatus properly calibrated? Yes ❑ No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? ❑ N/A ® Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? ■ N/A ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled N/A or disconnected? ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions ■ N/A or fails a test? LYesYe ❑ No* For electronic LLDs,have all accessible wiring connections been visually inspected? N/A❑ No* I Were all items on the equipment manufacturer's maintenance checklist completed? *In the Section H,below,describe how and when these deficiencies were or will be corrected. H. Comments: Replaced LLD in both 87 and 97 STP's. Vaporless LD2000. UN-036-3/4 Page 3 of 3 Rev.06/04/01 www.unidocs.org