COMPLIANCE INFO_PRE 2019 - Laserfiche WebLink

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F. In -Tank Gauging / SIR Equipment: X 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 be completed if in -tank gauging equipment is used to perform leak detection monitoring. Complete the followina 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? Tam Yes No* Were all probes reinstalled properly? Yes No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installe�NVIRONMENTAL HEALTH Complete the following checklist: DEPARTMENT x Yes - No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all i N/A that apply) Simulated leak rate: ❑x 3 g.p.h.; Q0.1 g.p.h ; ❑ 0.2 g.p.h. x Yes Ej No* Were all LLDs confirmed operational and accurate within regulatory requirements? if Yes - No* Was the testing apparatus properly calibrated? x Yes - No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? - N/A Yes i i No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? x N/A Yes F� No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or N/A disconnected? Yes - No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or _x N/A fails a test? Yes _ No* For electronic LLDs, have all accessible wiring connections been visually inspected? x N/A x Yes No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: Monitoring System Certification Page of 12/07