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2 � C SERVICES No • 1624 P . 4 <br /> F. In-Tank Gauging/SIR Equipment: puck this box if tilt gauging is used only for inventory control. <br /> ❑ puck 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 rollowfive ehecklist: <br /> MNo* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> • robes visually inspecw for damage and residue buildup? <br /> ❑ No Were all tank gauging p <br /> No* Was accursey of system product level readings tested? <br /> No• Was accuracy of system water level readings tested? <br /> ❑ No* Were all probes reinstalled properly? <br /> k ❑ Yes No• Were all items on the equipment manufacturer's maintenance checklist completed? <br /> "In the Section Il.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 /> Complete the followlaE checklist: <br /> YestNor equipment start-up or annual equipment certification, was a leak simulated to verify LLD Performance! <br /> Checkall that apply) Simulated leak rate: IW3g.p.k; 00.1 g.pb; ❑0.2g.p.h. <br /> Yesere all LLDs confirmed operational and accurate within regulatory requirements? <br /> Yesas the resting apparatus properly calibrued7 <br /> YesFor mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> ] YesFor electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> ❑ YesFor electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> or disconnected? <br /> ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut on a any portion of cite monitoring system malfunctions <br /> N/A or fails a test? <br /> ❑ Yes ❑ No* For electronic ILDs,have sll accessible wiring connections been visually inspected? <br /> N/A <br /> -j Yes M 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 03101 <br />