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F. In-Tank Gauging ! SIR Equipment: ® Check this box if tank gauging Is used only for inventory control. ❑ Check this box If no tank gauging or SIR equipment Is Installed. This section must he completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: ® 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? i ' in Section H, below, describe how and when these deficiencies were or will be corrected. i Line Leak Detectors (LLD): ❑ Check this box If LLDs are not installed. Complete the followln checklist: Yes ❑ 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 rale: ® 3 g.p.h.; ❑ 0.1 g , p.h ; ❑ 0.2 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 Now if It detects a leak? ❑ NIA ❑ 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? ! i ® NiA ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off If any portion of the monitoring system malfunctions or falls a test? ® N/A ❑ Yes ❑ No* For electronic LLDs, have all accessible wiring connections been visually Inspected? i IF4 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. i i H. Comments: 2!21 /07 Monitoring System Certification Page 3 of i i