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0 0 <br /> F. in-Tank Gauging/SIR Equipment: IN 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 /> ❑ 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 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 ❑ No* 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 /> C Yes ❑ No* For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance?(Check all <br /> ❑ N/A that apply) Simulated leak rate:®3 g.p.h.;Q0.1 g.p.h;[30.2 g.p.h. <br /> Ck Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> Ck Yes ❑ No* Was the testing apparatus properly calibrated? <br /> Cx Yes ❑ No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> ❑ N/A <br /> ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> A N/A <br /> ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or <br /> 19 N/A disconnected? <br /> ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or <br /> IR N/A fails a test? <br /> ❑ Yes ❑ No* For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> N/A <br /> a Yes ❑ No* 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 /> E11- <br /> JUN 0 2 201 <br /> VIRONMEN I AL HEALTH- <br /> EFAR MEN' <br /> Monitoring System Certification Page of 12/07 <br />