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E <br />F. In -Tank Gauging / SIR Equipment: <br />C <br />D Check this box if tank gauging is used only for inventory control. <br />N Check this box it no tank gauging or SIR equipment is installed. <br />This section must be completed if in -tank gauging equipment is used to perform teak detection monitoring. <br />Complete the following checklist: <br />F1 Yes <br />n No. <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />f i Yes <br />i i 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 />n Yes <br />n No* <br />Was accuracy of system water level readings tested? <br />❑ Yes <br />❑ No" <br />Were all probes reinstalled properly? <br />n Yes <br />n No` <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />in the 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 />Complete the following checklist: <br />u Yes <br />u <br />No' <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check a// <br />u <br />N/A <br />that apply) Simulated leak rate: _j 3 g.p.h.; _ 0.1 g.p.h ; u 0.2 g.p.h. <br />❑ Yes <br />❑ <br />No' <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />F1 Yes <br />n <br />No' <br />Was the testing apparatus properly calibrated? <br />❑ Yes <br />❑ <br />No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />0 <br />N/A <br />0 Yes <br />❑ <br />No` <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />❑ <br />N/A <br />u Yes <br />u <br />No` <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or <br />Li <br />N/A <br />disconnected? <br />❑ Yes <br />❑ <br />No` <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or <br />0 <br />N/A <br />fails a test? <br />n Yes <br />n <br />No` <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />n <br />N/A <br />❑ Yes <br />❑ <br />No' <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />in the section H, below, describe how and when these deficiencies were or will be corrected. <br />H. Comments: <br />Monitoring System Certification Page 3 of 4 12/07 <br />3 <br />2/21/07 <br />