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WO-9286 <br /> Monitoring System Certification <br /> F. In-Tank Gauging/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 must be completed if in-tank gauging equipment is used to perform leak detection monitoring. <br /> Complete the following checklist: <br /> ❑Yes rl No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> ❑Yes ❑No* Were all tank gauging probes visually inspected for damage and residue buildup'! <br /> ❑Yes ❑No* Was accuracy of system product level readings tested'? ocrOvrn <br /> n Yes , n No* Was accuracy of system water level readings tested? IUMM%0 V <br /> ❑Yes ❑No* Were all probes reinstalled properly? OR I I Nil <br /> ❑Yes E]No* I Were all items on the equipment manufacturer's maintenance checklist completed", NMENIAI HEA <br /> In the Section H,below,describe how and when these deficiencies were or will be corrected. PERMITISERMES <br /> G. Line Leak Detectors (LLD): ❑Check this box if LLDs are not installed. <br /> Conn lete the folio ing checklist: <br /> E3 Yes E]No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance'.' <br /> ON (Check all that apply) Simulated leak rate: C]3 g.p.h.: C]0.1 g.p.h; E]0.2 g.p.h. <br /> [j Yes n No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> 0 Yes ONo* Was the testing apparatus properly calibrated? <br /> [3 Yes []No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak'? <br /> ON/A <br /> OYes []No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak'? <br /> C3NIA <br /> 1:1 Yes []No* For electronic LLDs, does the turbine automatically shut off if any <br /> portion of the monitoring system is disabled <br /> []N/A or disconnected? <br /> El Yes EIN"o* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br /> ON/A Or filils a test'? <br /> ❑Yes 0 No* For electronic LLDs,have all accessible wiring connections been visually inspected! <br /> ON/A l <br /> 0 Yes [3No* I Were all items on the equipment manuf'acturer's maintenance checklist completed? <br /> In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: <br /> Page 3 of 3 <br />