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Monitoring System Certification <br /> 0 is <br /> F. In-Tank Gauging/SIR Equipment: 0 Check this box if tank gauging is used only for inventory control. <br /> El 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 E] No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br /> • Yes 0 No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> ED Yes El No* Was accuracy of system product level readings tested? <br /> • Yes 1171 No* Was accuracy of system water level readings tested? <br /> • Yes Ej No* Were all probes reinstalled properly? <br /> • Yes 171 No* 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): E] Check this box if LLDs are not installed. <br /> Complete the following checklist: <br /> 0 Yes 0 No* For equipment start-up or annual equipment certification, was a leak simulated to verify, LLD performance? 11 <br /> El N/A (Check all that apply) Simulated leak rate: 0 3 g.p.h.: El 0.1 g.p.h ; El 0.2 g.p.h. <br /> [D Yes 1-1 No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> • Yes [] No* Was the testing apparatus properly calibrated? <br /> • Yes Fj No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> El N/A <br /> 171 Yes n No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> 0 N/A <br /> El Yes 0 No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> 0 N/A or disconnected? <br /> E] Yes 171 N For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions <br /> 0 N/A or fails a test? <br /> F1 Yes F1 No* For electronic LLDs,have all accessible wiring connections been Visually inspected? <br /> 0 N/A <br /> Z Yes 0 No* 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 /> H. Comments: <br /> Page 3 of 4 <br /> UN-036—5/6 wwwain1does.org Rev.01117/08 <br />