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Onitoring System Certification 0 <br />Site Address: 755 S. TRACY BLVD <br />@ SCHULTE RD <br />F. In -Tank Gauging / SIR Equipment <br />Date of Testing/Service: 04/16/2002 <br />® Check this box if tank gauging is used only for inventory control. <br />M 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 />® Yes <br />❑ No * <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />ElYes <br />F-] No * <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />ElYes <br />[_1 No * <br />Was accuracy of system product level readings tested? <br />1-1 Yes <br />❑ No * <br />Was accuracy of system water level readings tested? <br />FjYes <br />❑ No * <br />Were all probes reinstalled properly? <br />ElYes <br />O No * <br />Were all items on the equipment manufacturers' maintenance checklist completed? <br />- In the Section n, below, describe now and wnen tnese deticiencies were or will be corrected. <br />G. Line Leak Detectors (LLD) : F] Check this box if LLDs are not installed. <br />Complete the following checklist: <br />® Yes <br />® No * <br />® N/A <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br />(Check all that apply) Simulated leak rate: ® 3 g.p.h ® 0.1 g.p.h ®0.2 g.p.h <br />® Yes <br />® No * <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />® Yes <br />F-1 No * <br />Was the testing apparatus properly calibrated? <br />El Yes <br />F-] No * <br />© N/A <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />® Yes <br />F_jNo * <br />F-1 N/A <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />® Yes <br />®No * <br />F-1 N/A <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br />® Yes <br />®No * <br />F-1 N/A <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? <br />® Yes <br />r_jNo* <br />1-1 N/A <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />MYes <br />[:]No * <br />Were all items on the equipment manufacturers' maintenance checklist completed? <br />- In the Section ti, below, describe now and wnen tnese deTiciencies were or will be corrected. <br />H. Comments: <br />PLLDS DUE 0.20 AND 0.10 TESTING LAST 0.10 TEST SUPER 4-16-02 RUL 3-12-02 <br />page 3 of 3 <br />