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1 <br /> Ill!-I'ank Ganging /St It Eltlrtt11t1LIlf. U Check this box if t,!!tk ganging is used only for inventory control. <br /> U Check this box it'no lank gauging or SIR equipment is installed. <br /> This section must be completed if 111-fank gatlging ctluipillelit is used to put-)rm leak detection monitoring. <br /> Complete the following checklist: <br /> ❑ Yes l❑ No* Has all input wiring been inspected for proper entry and termination, inchrding testing for ground faults? <br /> ❑ Yes ❑ No* Were all Intik ganging probes visually inspected tilt, elating(: and residtic httil(lttp? <br /> Cl Yes ❑ No Was accuracy of system product icvel readings Icstew �— <br /> ❑ Yes LJNo* Was accuracy of syslcrn water level readings tested? <br /> O Yes ❑ No* Were all probes reinstalled properly'? <br /> ❑ Yes ❑ No* Were all items on the equiprncttt tnanttlachrrcr's titaintenance checklist completed? <br /> *In the Section H,below, describe how and when these deficiencies were or will he cnr recteil. <br /> G. Line beak Uetectot's U t 'hef•k Iltis ImX if l.t,l)s ;tic not in.slalled. <br /> Com )tete the following checklist: <br /> Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br /> ❑ N/A (Check all that apply) Simulated leak rate: 0-7-9-01.; ❑ 0.I g.p.lr ; ❑ 0.2 g.p.h. <br /> Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> Yes LJNo* Was the testing apparatus properly calibrated? <br /> Yes U No* For mechanical LLDs, does the 1.1,1) restrict product flow if it detects n leak? <br /> ❑ N/A <br /> Ll Yes Q No* For electronic LI,Ds, docs the turbine autonlatically shut off if the LLD detects a leak? <br /> ❑ Yes U No* i-or electronic LLDs, does the Itnhitie atrtornatically shut off if any portion of the monitoring system is disabled <br /> Cr-P/A or disconnected? <br /> ❑ Yes U No* For electronic LLDs, docs the hnbinc automatically shut off if any portion of the monitoring system <br /> O—N/A malfunctions or fails n testa <br /> ❑ Yes U No* For electronic LLDs, have all accessible wiring connections been visually inspected? <br /> 0—TWA <br /> Yes ❑ No* Were all items on the equipment 11171raclurer's "I'linlen,ancecltccklist completed? <br /> fn the Section 11,below, describe [row and when Ilrese deficiencies were or will be corrected. <br /> H. Comments: <br /> P ige 3 of 3 03101 <br />