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1t -Tank- Gauwng/SIR <br /> *Pment. Check this box if tank Gg <br /> 4auginA is used anly to,- <br /> 12 Check this box if no tank gaining or SIR equipment is installed_ <br /> This section must be completed if in-tank gauging equipment is used to perforin leak detection monitoring. <br /> Corn tete the fop-awing checklist: Y <br /> ❑ Yes ❑ No Has all input wiring been inspected for proper entry and termination, including testin=faul,7- <br /> El <br /> ❑ Yes ❑ No* Were all tank gauging probes visually inspected far damage and residue buildup? <br /> Yes ❑ No* Was accuracy of system product level readings tested? <br /> ❑ Yes ❑ No* Was accuracy of system wafter level readings tested? <br /> ❑ Yes ❑ No* Were all probes reinstalled properly? <br /> ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> * In the Section 11,below,describe how and when these deficiencies were or will be corrected. <br /> G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br /> Com tete thefollowin checklist: <br /> Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance' <br /> ❑ N/A (Checkall[hat apply) Simulated leak rate: 513 v. <br /> P•h.; ❑Q.l g.p.h; ❑0.2 g.p.h. <br /> id Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> IB Yes ❑ No* Was the testing apparatus properly calibrated? <br /> 21 Yes ❑ No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> ❑ N/A <br /> ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shu <br /> 10 N/A kt off if the LLD detects a lea <br /> Yes fel❑ No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> NIA or disconnected? <br /> ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system <br /> ® N/A malfunctions or fails a test? <br /> ❑ Yes . © No* For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> lia N/A <br /> Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> *In the Section H,below,describe how and when these delyciencies were or will be corrected. <br /> H. Comments: <br /> 0 <br /> Page 3 of3 <br /> 03/ill <br />