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Site Address: <br />--- Date of Testing/Servicing: <br />F: In-Tank Gauging /SIR Equip—ent: <br />Check this box if tank gauging is used only for inventory control. <br />4 LJ Check this box if no tank g <br />If auging or SIR equipment is installed <br />This section must be completed if in -lank gauging equipment is used to perform leak detection monitoring. <br />Complete the following checklist: <br />❑ Yes ❑ No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />❑ Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? <br />❑ Yes ❑ No* Was accuracy of system product level readings tested? <br />❑ Yes ❑ No* Was accuracy of system water level readings tested? <br />❑ Yes ❑ No* Were all probes reinstalled properly? <br />❑ Yes ❑ 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 />G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />Co pfete the following checklist: <br />For equipment start-up or annual equipment ertification, was a leak simulated to verify LLD performance? <br />(Check all !ha! apply) Simulated leak rater g,p.h,; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />Were all LLDs confir►ned operational and accurate within regulatory requirements? <br />q[j <br />Was the testing apparatus properly calibrated? <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />Ior disconnected? <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system <br />malfunctions or fails a test? <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />In the Section H, below, describe how end when these deficiencies were or will be corrected. <br />L Comments: <br />