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Monitoring System Certification <br />F. In -Tank Gauging / SIR Equipment: ❑ Check this box if tank gauging is used only for inventory control. <br />Q 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 pert Drm leak detection monitoring. <br />Complete the following checklist: <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 />❑ Yes <br />❑ No* <br />Was accuracy of system product level readings tested? <br />❑ Yes <br />❑ No* <br />Was accuracy of system water level readings tested? <br />❑ Yes <br />❑ No* <br />Were all profs reinstalled properly? <br />❑ 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): ❑ Check this box if LLDs are not installed, <br />CmmnletQ thn 1`nllnwinu rhoeirlimt! <br />® Yes <br />❑ No* <br />❑ N/A <br />For equipment start-up or annual equipment certification, was a leak sitnulated to verify LLD performance? <br />(Check all that apply) Simulated leaf rate: ® 3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p-lr- <br />® Yes <br />❑ No* <br />Were all LLD& confirmed operational and accurate within regulatory requirements? <br />JE Yes <br />❑ No* <br />was the testing apparatus properly' calibrated? <br />® Yes <br />❑ No* <br />❑ N/A <br />For mechanical LLDs, does the IrI.D restrict product flow if it detects a leak? <br />❑ Yes <br />❑ No* <br />® N/A <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />❑ Yes <br />❑ No* <br />® N/A <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 />10 N/A <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br />or fails a test? <br />❑ Yes <br />❑ No* <br />® N/A <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />® Yes <br />Q No* <br />Were all items on the equipment manufactt rer's maintenance checklist completed? <br />* In Section <br />H. below. describe how and when these deficiencies were or will be corrected. <br />H. Comments: <br />Page 3 of 4 <br />www.110idoes.org <br />Rev. 01/17/88 <br />