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N� ...'w F. In -Tank Gauging / SIR Equipment: r Check this box if tank gauging is used only for inventory control. *r Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: Yes No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? Yes No* Were all tank gauging probes visually inspected for damage and residue buildup? Yes No* Was accuracy of system product level readings tested? Yes No* Was accuracy of system water level readings tested? " Yes No* Were all probes reinstalled properly? N� Yes No* Were all items on the equipment manufacturer's maintenance checklist completed? 4 9 44 * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): *P Check this box if LLDs are not installed. Complete the following checklist: X ENVIRONMENTAL HEALTH Yes No* For equipment start-up or annual equipment certification was a leak simulated to verity LLD performance? (Check a# that t� app/y) Simulated leak rate: r 3 g.p.h.; r 0.1 g.p.h; 0.2 g.p.h. N/A Yes No* Nere all LLDs confirmed operational and accurate within regulatory requirements? Yes No* Nas the testing apparatus properly calibrated? Yes No* For mechanical LLDs, does the LLD restrict product Flow if it detects a leak? N/A • Yes No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? N/A • Yes No* For electronic LLDs that are programmed for positive shut down, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? N/A Yes No* For electronic LLDs that are programmed for positive shut down, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? N/A Yes No* For electronic LLDs, have all accessible wiring connections been visually inspected? N/A Yes No* Nere all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. Page 3 of 3 12/07