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Jun 14 05 10: 10p M# Dotten f2016 533-2650 p. 3 <br /> Facility: I.,inden Associated Growers Page 3 <br /> In-Tank Gauging/SIR Equipment: <br /> ❑Check this box if tank gauging is used only for inventory control and disregard the following section. <br /> ®Check this box if no tank gauging or SIR equipment is installed and disregard the following section, <br /> (This section must be completed ifin-tankgauging equipment is used to perform leak detection monitoring). <br /> Cam Leta the foil ing checklist: <br /> ❑Yes ❑ No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br /> ❑Yes ❑ No* Were all tank-gauging probes visually inspected for damage and residue buildup? <br /> ❑Yes ❑ No* Was accuracy of system product level readings tested'? <br /> Yes ❑ No* Was accuracy of system water level readings tested? <br /> ❑Yes ❑ No* Were all probes reinstalled properly? <br /> ❑Yes ❑ No* I Were all items on the equipmenl manufacturer's maintenance checklist completed? <br /> *In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> G. Line Leak Detectors (LLD): <br /> 2 Check this box if LLDs are not installed and disregard the following section. <br /> ❑Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br /> ❑ NIA (Check all that apply) Simulated leak rate: ❑ 3 g.p.h.; ❑0.1 g.p.h; ❑0.2 g.p.h. <br /> ❑Yes ❑ No* Were aEl LLDs confirmed operational and accurate within regulatory requirements? <br /> ❑Yes ❑ No* Was the testing apparatus properly calibrated? <br /> Yes ❑ No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> ❑ NIA <br /> ❑Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> ❑ N/A <br /> ❑Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> ❑ N/A or disconnected? <br /> Q Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system <br /> El N/A malfunctions or fails a test? <br /> ❑Yes ❑ No* For electronic LLDs, have all accessible wiring connections been visually inspected? <br /> ❑ NIA <br /> ,LqYes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> *In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: No deficiencies. <br /> Page 3 of 3 U3101 <br />