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C?ETTtER-RYAN INC. GR Job# 20-641524 <br /> WA <br /> F. In-Tank Gauging if 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 /> U Yes --[-3---190—Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> [L- Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> [I Yes ❑ No* Was accuracy of system products level readings tested? <br /> Ia Yes ❑ No" Was accuracy of system water level readings tested? <br /> [j Yes ❑ No* Were all probes reinstalled properly? <br /> Yes 1 ❑ No* lWere all items or the equipment manufacturer's maintenance checklist completed? <br /> n the Section H,below,describehow ana wnen these deficiencies were or will be corrects . <br /> G. Line Leak Detecton3(LLD): ❑ Check this box if LLDs are not installed. <br /> Complete the following checklist: <br /> 'I as ❑ o or equipmentstart-up or annus equipmentcertification,was a a simu a verilyperformance?7F -527 all <br /> ❑ N/A that apply)Simulated leak rate: ® 3 g.p.h. ❑ 0.1 g.p.h. ❑ 0.2 g.p.h. <br /> r Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> 1 Yes ❑ No* Was the testing apparatus properly calibrated? <br /> ❑ Yes ❑ No* For Mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> Id N/A <br /> Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> ❑ N/A <br /> ra Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled or <br /> ❑ N/A Disconnected? <br /> Ia Yes ❑ No* For electronic Us,does the turbine automatically shut off if any portion of the monitoring system malfunctions or <br /> ❑ N/A fails a test? <br /> 11A Yes ® No* For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> ❑ N/A <br /> Yes I g No* were all items on the equipment manufacturer's maintenance checklist completed? <br /> In the Section H,below,describe ow and when these deficiencies were or Will be corrected. <br /> G. Comments: <br /> Monitoring System Certification Page 3 of 4 t7J07 <br /> 3 <br />