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e h E, -, F. In -Tank Gauging / SIR Equipment: ❑ Check this box K tank gauging is used only for inventory control. ❑ Check this box N no tank gauging or SIR equipment is installe This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. �� ❑ complete the tonowmg cnecxust: I Yes ❑ No' Has all input wiring been inspected for proper entry and termination, including testing for ground faults? ❑ Yes ❑ No' Were all tank gauging probes visually inspected for damage and residue buildup? ❑ Yes ❑ No' Was accuracy of system product level readings tested? ❑ Yes ❑ No* Was accuracy of system water level readings tested? ❑ Yes ❑ No* Were all probes reinstalled properly? ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? - in oecuon n, oerow, uwwriue nuw aim when auvav umw.mw.va wv.v — -1.1 .,a —1 -- Line Leak Detectors (LLD): ® Check this box if LLDs are not installed. ❑ Yes _ v❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) ❑ N/A Simulated leak rate: ❑ 3 g.p.h.; ❑ 0.1 g.p.h; [10.2 g.p.h. ❑ Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? ❑ Yes ❑ No* Was the testing apparatus properly calibrated? ❑ Yes ❑ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ❑ N/A ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ❑ N/A ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? ❑ N/A ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? ❑ N/A ❑ Yes ❑ No' For electronic LLDs, have all accessible wiring connections been visually inspected? ❑ N/A ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: SUCTION Monitoring System Certification Page 3 of 4 2/21/07