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19255517888 Main Fax GETTLER RYAN INC 1' ,q:35 p.m. 01-11-2007 4/11 F. In -Tank Gauging / SIR Equipment: ❑ Check this box if tank gauging is used only for inventory control. ❑ 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. Comnlete the following checklist: ^ /I///+- - to the becuon ii, oeiow, ucacrnue 11— 4.... G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. . f-,....,.1oto rt,o rnitnwina rhrrkiictc — N/ A- I.— Cl Yes No* Has ail input wiring been inspected for proper entry and termination, including testing for ground faults? R❑ ❑ 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? ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? to the becuon ii, oeiow, ucacrnue 11— 4.... G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. . f-,....,.1oto rt,o rnitnwina rhrrkiictc — N/ A- I.— Cl Yes O No* For equipment start-up or annual equ ment certification, was a leak simulated to verify LLD performance? ❑ N/A (Check all that apply) Simulated leak rate: ❑ 3 g.p.h.; 0 0.1 g.p.h ; ❑ 0.2 g.p.h. ❑ Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? ❑ Yes ❑ No* Was the testing apparatus properly calibrated? ❑ Yes ❑ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ❑ N/A O Yes ❑ No' For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ❑ N/A ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled ❑ N/A or disconnected? ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system ❑ N/A malfunctions or fails a test? O Yes ❑ No* For electronic LLDs, have all accessible wiring connections been visually inspected? ❑ N/A ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or wit ne correctea. H. Comments: Page 3 of 3 03101