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Site Address: Date of Testing/Servicing:_I <br /> F. In-Tank Gauging/SIR Equipment: C1 Check this box if tank g ging is used only for inventory control. <br /> ❑ 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 /> JE] Yes ffNo* as all input wiringbeen inspected for proper entry and termination, including testing for ground faults? <br /> ere all tank gauging probes visually inspected for damage and residue buildup?as accuracy of system product level readings tested? <br /> as accuracy of system water level readings tested? <br /> ere all probes reinstalled properly? <br /> ere 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 /> EJ-Y�es ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br /> ❑ N/A (Check all1hal apply) Simulated leak rate: 8-1'9P.1i.; 130-1 g,p,h ; ❑ 0.2 g.p.h. <br /> Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> es ❑ No* Was me testing apparatus properly calibrated? <br /> es ❑ No* For mechanical LLDs, does the LLD restrict product flow if i[detects a leak? <br /> ❑ N/A <br /> ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br /> 3--W/—A <br /> ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> p'�(%A or disconnected? <br /> ❑ Yes ❑ No* For electronic LLDs, does [lie turbine automatically shut off if any portion of the monitoring system <br /> 9' Jg/A malfunctions or fails a test? <br /> ❑ Yes ❑ No* For electronic LLDs, have all accessible wiring connections been visually inspected? <br /> ErN/A <br /> Ll Yes I ❑ 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 />