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Section 12: Release Detection (cont’d.)

[ ] Applicable [ ] Not Applicable

Section 12.b. Vapor Monitoring (Tanks and/or Piping)

#

Complete 1. Answer (P)ass, (PC), (F)ail or (NA) for 2 11.

Tank #

___

Tank #

___

Tank #

___

Tank #

___

Tank #

___

1

Console Make and Model

Make: Model:

2

Monitoring panel and/or control box is working.

3

4

Verification that the Vapor Monitoring device is third-party approved and on the NWGLDE* list. Owner's manual for the Vapor Monitoring device is available at the site.

5

The material used as backfill is sufficiently porous, such as pea gravel or sand, to readily allow diffusion of vapors from releases into the excavation zone.

6

Vapor Monitors are designed, calibrated, and operated to detect an increase in concentration of the regulated substance, a component of the regulated substance, or a tracer compound placed in the tank system and maintained per manufacturer's instructions in addition to limitations listed on evaluation summary NWGLDE* list.

7

Site evaluation report is on site and verifies the above information and that background contamination will not interfere with vapor monitoring. Attach evaluation cover page. System setup reviewed and proper settings confirmed correct. Verification all probes functioning.

8

9

Vapor Monitors are checking portion of tank and piping that routinely contain product.

10

Monthly release detection records are available for last 12 months.

11

Existing release detection results show no evidence of a release.

Vapor Monitoring passes inspection. Questions 2 – 11 are (P) or (PC)

Note: If the answer to any question is (F), please explain below. List any problems noted during inspection. Note corrections.

  • *

    www.nwglde.org (National Work Group on Leak Detection Evaluations).

Comments: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Form Number: MDE/WAS/COM.055 Date: April 3, 2007 TTY Users: 800-735-2258

Facility I.D.

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