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i 0 GEMER-Rwif INc. 6 GR Job # F. In -Tank Gauging 1 SIR Equipment: [K 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 teak detection mi r ' V E L",; Complete the following checklist: U"'U "'vHas all input wiring been inspected for proper entry and termination, including testing for p Yes ❑ No ' Were all tank gauging probes visually inspected for damage and residue buildup? ❑ Yes ❑ No` I Was accuracy of system products level readings tested? Q Yes [� No' Was accuracy of system water level readings tested7 ❑ 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 wgrg or will be corrected. G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. complete the following checklist: ❑ es❑ rqilpmen start -up -or annus equipment ce r ca eon, was a ea simu a o ven peo o eapupy)Simulated NA leak rate: ❑ 3gii [1 0,1 g.p.h. [1 0.2 g.p,h ❑ Yes ❑ No' I Were all LLDs confirmed operational and accurate within regulatory requirements? Yes ❑ No' lWas the testing apparatus properly calibrated? ❑ Yes ❑ No' For Mechanical LL Ds, does the LLD restrict product flow if it detects a leak? ❑ NIA ❑ Yes ❑ No' For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ❑ NIA ❑ Yes ❑ No' For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system ❑ NIA Disconnected? ❑ Yes ❑ No' For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system Q NIA fails a test? ❑ Yes ❑ No' For electronic LLDs, have all accessible wiring connections been visually inspected? ❑ NIA all items on the equipment manufacturer's maintenance checklist completed? ibe how and w en these deficiencies were or will be corrected G. Comments: Did not test PLLD Iden, rQ nC74 or is'or Monitoring System Certification Page 3 of 4 12107 3 Ai IT