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F. In -Tank Gauging / SIR Equipment: r Check this box if tank gauging is used only for <br />ntrEIVED <br />r Check this box if no tank gauging or SIR equp n <br />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring, MAY <br />2 6 2015 <br />Complete the following checklist: H I <br />• Yes r No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? — RON ENTAL <br />• Yes r No* Were all tank gauging robes visual) inspected for damage and residue buildup? - gT!IAChIT <br />9 9 9P Y P 9 P <br />Yes r No* Was accuracy of system product level readings tested? <br />r Yes r No* Was accuracy of system water level readings tested? <br />Ir Yes No* lWere all probes reinstalled properly? <br />ir Yes Ir 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): r Check this box if LLDs are not installed. <br />Complete the following checklist: <br />{e Yes <br />r No* <br />For equipment start-up or annual equipment certificationwasa leak simulated to verify LLD performance? (Check all that <br />apply) Simulated leak rater 3 g.p.h.; r 0.1 g.p.h; 1 0.2 g.p.h. <br />N/A <br />G Yes <br />r No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />• Yes <br />r No* <br />Was the testing apparatus properly calibrated? <br />Yes <br />r No* <br />For mechanical LLDs, does the LLD restrict product Flow if it detects a leak? <br />• N/A <br />to Yes <br />r No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />N/A <br />t? Yes <br />[, No* <br />For electronic LLDs that are programmed for positive shut down, does the turbine automatically shut off if any portion of the <br />monitoring system is disabled or disconnected? <br />N/A <br />fa" Yes <br />No* <br />For electronic LLDs that are programmed for positive shut down, does the turbine automatically shut off if any portion of the <br />ir N/A <br />monitoring system malfunctions or fails a test? <br />G Yes <br />r No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />N/A <br />Ce Yes <br />r No* <br />ere all items on the equipment manufacturer's maintenance checklist completed? <br />* In the Section H, below, describe how and when these deticiencies were or will De corrected. <br />Page 3 of 3 12/07 <br />