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C�7 A 6frrLER-RYAN INC. GR Job # 20-591947 F. In -Tank Gauging / SIR Equipment: ❑ 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. Comnleto tho fnilnurinn rhwrklist- 9 yes 1 ❑ o Has all input wiring been inspected for proper entry and termination, including testing for ground faults? [j Yes 1 ❑ No" Were all tank gauging probes visually inspected for damage and residue buildup? ff Yes ® No" Was accuracy of system products level readings tested? ff Yes ❑ No" Was accuracy of system water level readings tested? ry Yes I] NW Were all profs reinstalled property? Ej Yes ❑ No* Were all stems on the equipment manufacturees maintenance checklist completed? G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. Comollete the following checklist: rg Yes ❑ o o -equipment start-up or annual equipment cern cation, was a leak simulated to verify D performance? (cherk all ❑ NIA that apply) Simulated leak rate: ® 3 g.p.h. ❑ 0.1 g.p.h. ❑ 0.2 g.p.h. ff Yes ❑ No" Were all LLDs confirmed operational and accurate within regulatory requirements? [j Yes ❑ No" Was the testing apparatus properly calibrated? ❑ Yes ❑ No" For Mechanical LLDs, does the LLD restrict product flow if it detects a leak? E NIA ff Yes ❑ No" For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ❑ WA m Yes ❑ No" For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or ❑ NIA Disconnected? a Yes ❑ No" For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or ® NIA fails a test? Yes No" For electronic LLDs, have all accessible wiring connections 6Wn visually inspected? NIA r& Yes ❑ Ne were all items on the equipment manufacturer's maintenance checklist completed? In vie Section h, below, describe now and when these deficiencies were or will be corrected. G. Comments: Monitoring system Certification Page 3 of 4 12107 0