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onitoring System Certification 41 <br /> Site Address: 2360 GRANTLINE, 1-205 OFF RAMP Date of Testing/Service: 05/22/2001 <br /> MARKET#2237 <br /> F. In-Tank Gauging /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 preform leak detection monitoring <br /> Complete the following checklist: <br /> ❑ Yes ❑No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> ❑ Yes ❑No• Were all tank gauging probes visually inspected for damage and residue buildup? <br /> ❑ Yes ❑No* Was the accuracy of system product level readings tested? <br /> ❑Yes ❑No* Was accuracy of system water level readings tested? <br /> ❑ Yes ❑No, Were all probes reinstalled properly? <br /> ❑ Yes EjNo-I Were all items on the equipment manufacturers maintenance checklist completed? <br /> G. Line Leak Detectors (LLD) : ❑ Check this box if no tank gauging or SIR equipment is installed. <br /> Complete the following checklist: <br /> For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance? <br /> ® Yes ®No* ❑N/A (Check all that apply)Simulated leak rate:®3 g.p.h®0.1 g.p.h ❑0.2 g.p.h <br /> ® Yes ®No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> ® Yes ❑No* Was the testing apparatus properly calibrated? <br /> ®Yes ❑No* ❑ N/A For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> ❑Yes [:]No* ® N/A For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> ❑Yes ❑No* ® N/A For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected. <br /> Yes No* P9 N/A For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? <br /> ❑Yes ❑No* ® N/A or electronic LLDs,have all accessible wiring connections been visually inspected? <br /> ❑Yes ®No* Nere all items on the equipment manufacturers maintenance checklist completed? <br /> *In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: <br /> NO POSITIVE SHUTDOWN. NO SENSOR OUT SHUTDOWN, NO MAINTENANCE CHECKLIST. <br /> page 3 of 3 <br />