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Underground Storage Tank <br /> Monitoring System Certification Form <br /> B. IN-TANK GAUGING TESTING <br /> ® Check this box if tank gauging is used only for inventory control. <br /> LJ Check this box if NO tank gauging equipment is installed. Yes No NA <br /> Do not complete this section if either box is checked. <br /> All wiring has been: 1)visually inspected for kinks, breaks and proper entry and Ll Lj z <br /> termination; and 2 tested for ground faults? <br /> Were all in-tank gauging probes visually inspected for damage and residue buildup 0 Ll z <br /> to ensure that floats move freely, functionally tested, and confirmed operational? <br /> Was accuracy of system's product level readings tested? Ll A A <br /> Was accuracy of system's water level readings tested? U Ll <br /> Were all probes reinstalled properly? D Ll 21 <br /> Were all items on the equipment manufacturer's maintenance checklist completed? Ll Ll A <br /> Probe 1D Probe Mode! Tanks Monitored Pass Fail <br /> T1 847390-109 Supreme 0 L) <br /> T2 847390-109 Regular R) Ll <br /> T3 847390-109 Dsl Il <br /> Lj D <br /> Il Il <br /> ® 0 <br /> 9. COMMENTS <br /> Describe all answers marked "No"or"Fail'and proposed remedy. <br /> List all monitoring equipment either replaced or repaired. <br /> Page 5 of 6 <br />