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F. in-Tank GauOng/SER Equipment: Check this box if lank gauging is used only for inventory control. <br /> `S Check this box if no tank gauging or SIR equipment is installed. <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitorin,. <br /> E <br /> fono ' checklist"No' Has all input wrtmg beeninspe cted for proper®try and termination.mdudmg testing for ground faults? <br /> No* Were all tank ganging probes visually inspected for damage and residue 6mldup? <br /> No- Was arcwecv of system product level readings tested? <br /> No* Was accuracy of system water level readings tested? <br /> No* Were all prdhbes reinstalled propealy?No* Were all items on tffi equipment ManafactU cr's maintenance checklist complenxl? - <br /> *in the Section S,below,describe hoer and when Umse were ar wM be corrected. <br /> G. Line Leah Detectors(LLD): ❑ Chcck this box if LLDs are not installed- <br /> rm thefollowin checldist: <br /> vo* For eyiripmeor start-up or annual equipmentdxltifirarion, was a leak simlaitd to verify LID pexformatte? <br /> 0 N/A (Check all dw apply) Simulated leak tate:c13 g p.h: 0 0.1 g ph: 0 02 g.ph Cl No- Were all LLDs confirmed operational and accurate within reguiatmY regooca"c' ts? <br /> Yes O No= Was the tcdn appatn ns properly cahbrated? <br /> es ❑ No* For mechanical LLDs,docs the LLD rrstrim produetilow ifit detects a leak. <br /> Cl NIA <br /> Cl Yes D Pio* I For eledoruroc UDs.does the turbine avtome>icallY shat oififthe LLD de ear a leak? <br /> 0 NIA <br /> 0 Yes 0 No* For electronic LL M does the turbine automatically shut off u any portion of the monitoring sys»m is dsabled <br /> Ea MA or.turn nectcdr? <br /> ❑Yes 0 Nox For elaclronic LIAh,dxs clue iabine avto®atinlly slum off if any portion of dm Muniutri>,r sysrmn rnalfimctioas <br /> - 0 NIA or fails a test? <br /> 0 Yes 0 ?do* For clecirmw LLDs,have all accesvble wi ing connections been visually inspected? <br /> 0 MA <br /> -Yrs 113 No* W=,U items the equipment manmfactmees ahauaenanre checklist completedl <br /> x in the Section H,below,desrnbe how and wig¢these defide0cieg were or wit be corrected_ <br /> H. Comments; f i i 4 2%, (' s- C p t X/n�� C4t; <br /> Ply,S Q 3 4 I 1 1 4.1o'l----- <br /> f7. o � <br /> Page 3 of 3 03101 <br />