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0 RE*EIVED <br /> Monitoring System Certification <br /> D L'C 2 4 201 <br /> t cl_`,Nrl.11'­111.nn GV <br /> F. In-Tank Gauging/SIR Equipment: M Check this f Fd f entory control. <br /> �01 �ill Yt <br /> 0 Check this LiO VWqe installed. <br /> ijbko q nt is <br /> c,P <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. <br /> ZD <br /> Complete the following checklist: <br /> El Yes El No* Has all input wiring been inspected for proper entry and termination,including testing for-round faults? <br /> El Yes 7 No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> 0 Yes F-1 No* Was accuracy of system product level readings tested? <br /> El Yes 7 No* Was accuracy of system water level readings tested? <br /> E] Yes E] No* Were all probes reinstalled properly? <br /> El Yes El No* I 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): El Check this box if LLDs are not installed. <br /> Complete the following checklist: <br /> M Yes F-1 No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br /> El N/A (Check all that apply) Simulated leak rate: M 3 g.p.h.; El 0.1 g.p.h El 0.2 g.p.h. <br /> 0 Yes F No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> M Yes F No* Was the testing apparatus properly calibrated? <br /> E] Yes M No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> M N/A <br /> Z Yes F No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> El N/A <br /> Z Yes F No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> F N/A or disconnected? <br /> Z Yes R No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br /> [:1 N/A or fails a test? <br /> M Yes R No* For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> El N/A <br /> M 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 /> H. Comments: <br /> Page 3 of 4 <br />