Laserfiche WebLink
• tK/Ar i <br /> Site Address: - <br /> ''g?rlate of Testing/Scrvicing: <br /> F. Iii-Tank Gauging/SIR Equipment: Check this box if tank gauging is used only for inventory conjrol. <br /> ❑ Cluck this box if no tank gauging or SIR equipment is installid. <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. ; <br /> Complete the following checklist: <br /> 4 11 Yes gNo <br /> H <br /> asut wiring been inspected for proper entry and termination, including testing for ground faults? <br /> 1'es nk gauging probes visually inspected for damags and residue buildup? <br /> Yes No' accuracy of system product level readings tested? <br /> Yes cy of system water level readings tasted? <br /> Yes obes reinstalled Ea <br /> Yes ms on the equipathemrer's mEE]�list completed'? <br /> *In the Section H,below,describe how and when these dencieacies were or will be corrected, <br /> G. Line Leak Detectors (LLD): Cneck this box if LLDs are not instated <br /> Compote the following checklist: <br /> 19 Yes I ❑ No* For equipment start-up or annual equipme qt_certification, was a leak simulated to verify LLD performance? <br /> C3N/A (Check all that apply) Simulated leak race. W3 g p.h,'; O o.l g.p,h,r; ❑0.2 g.p.h.'- <br /> Notes: I. Required for equipment start-up ecrtificadon Wil annual certification. <br /> 2. Unless mandated by local agency,certification required only for electronic LLD stall-up. <br /> es ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements'? <br /> Yes Cl No" Was the hating apparatus properly calibrated? <br /> Yes ❑ No" For mechanical LLDs,does the LLD restrict product flow if it datects a leak? <br /> O N/A <br /> ❑ Yes ❑ No's For elecUonic LLDs,docs the nubine a nomadcally shut off if die LLD detects a Itak'7 <br /> N/A <br /> �j Yes ❑ No* For electronic LLDs,does the turbine automatically strut off if any portion of the monitoring system is disabltd <br /> N/A or disconnected? <br /> ❑ Yes ❑ No* Fur electron c LLDs does the turbine automatically strut off if any ponfon of the monitoring system <br /> N/A malfunctions or fails a test? <br /> ❑ Yes ❑ No, For electronic LLUs,have all accessible wiring Connections been visually inspected? <br /> N/A <br /> Yes ❑ No* Were all items on the equipment manufachuerb maintenance checklist completed? <br /> •In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> C'2 <br /> �e- jejr <br /> C <br /> d r <br /> CALM-4I Page 7*0 <br /> 11/15179; <br /> l <br />