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F. In -Tank Gauging / SIR Equipment: III Check this tax if tank gauging is used only for inventory control. <br />F 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 />r Yes <br />No* <br />Has all input wiring been inspected for proper entry and termination, including ming for ground faults? <br />r Yes <br />r No* <br />Nere all tank gauging probes visually inspected for damage and residue buildup? <br />Yes <br />r No* <br />Nas accuracy of system product level readings tested? <br />r Yes <br />r No* <br />Nas accuracy of system water level readings tested? <br />Yes <br />r No* <br />Nere all probes reinstalled properly? W <br />f Yes <br />r No* <br />Nere 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): Check this box if LLDs are not installed. <br />Complete the following checklist: <br />:. .-,.. ., c CJ It <br />ENVIRONMENTAL HEALTH <br />rP'Dr: "ENT <br />Yes <br />r No* <br />For equipment start-up or annual equipment certification was a leak simulated to verify LLD performance? <br />� <br />Simulated leak rate: F 3 g.p.h.; r 0.1 g.p.h; 0.2 g.p.h. <br />N/A <br />Yes <br />r No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />r Yes <br />r No* <br />Was the testing apparatus properly calibrated? <br />r Yes <br />r No* <br />For mechanical LLDs, does the LLD restrict product Flow if it detects a leak? <br />N/A <br />• Yes <br />No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />N/A <br />•Yes <br />No* <br />or electronic LLDs that are programmed for positive shut down, does the turbine automatically shut off if any portion of the <br />onitoring system is disabled or disconnected? <br />N/A <br />• Yes <br />No- <br />r electronic LLDs that are programmed for positive shut down, does the turbine automatically shut off if any portion of the <br />nitoring system malfunctions or fails a test? <br />N/A <br />r Yes <br />No* <br />or electronic LLDs, have all accessible wiring connections been visually inspected? <br />N/A <br />Yes <br />r No* <br />Pere all items on the equipment manufacturers maintenance checklist completed? <br />* In the Section H, below, describe how and when these deficiencies were or will be corrected. <br />Page 4 of 4 12/07 <br />