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F.In-Tank Gauging/SIR Equipment: r Check this box if tank gauging is used only for inventory control. <br /> r 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 monitoring. <br /> Complete the following checklist: <br /> + Yes ' No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br /> + Yes C' 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 r No* Was accuracy of system water level readings tested? <br /> • Yes l� No* Were all probes reinstalled properly? <br /> + Yes r 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 /> G.Line Leak Detectors(LLD): r Check this box if LLDs are not installed. <br /> ENVIRONMENTAL HEALTH <br /> Complete the following checklist: nF.PART ENT <br /> + Yes �' No* For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance?(Check all that <br /> C` N/A apply)Simulated leak rate:P 3 g.p.h.; r 0.1 g.p.h; r 0.2 g.p.h. <br /> + Yes ' No* Were all 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 /> C' N/A <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 that are programmed for positive shut down,does the turbine automatically shut off if any portion of the <br /> l+ N/A monitoring system is disabled or disconnected? <br /> Yes r No* For electronic LLDs that are programmed for positive shut down,does the turbine automatically shut off if any portion of the <br /> G N/A monitoring system malfunctions or fails a test? <br /> Yes r No* For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> G N/A <br /> • Yesf 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: <br /> Page 3 of 3 12/07 <br />