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F: In-Taal: Gauging/SIR E,,_.pment: ❑ Check this box ii .alk 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 perfot7rl leak detection monitoring. Cam Tete the following checklist: es ❑ No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? es ❑ No*� Were all tank gauging probes visually inspected for damage and residue buildup'? S El No* Was a:curacy of system product level readings tested? es ❑ No* Was accuracy of system water level readings tested? _ es ❑ No* Were all probes reinstalled properly? Yes ❑ No* I Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. Co tete the following checklist: Yes ❑ No* For equipment start-up or annual equipment c irication, was a leak simulated to verify LLD performance? . ❑ N/A (Check all that apply) Simulated leak rate: 3 g.p.h.;- ❑ 0.1 g.p.h; ❑ 0.2 g.p.h. s ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? S ❑ No' Was the testing apparatus properly calibrated? i' Yes ❑ No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? ❑ N/A i ❑ Yes ❑ o* For ele;ionic LLDs, does the turbine automatically shut off if the LLD detects a leak? N/A is ❑ Yes ❑ d"o* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled Vd 1`'/A or disconnected? tj ❑ Yes ❑ e 'o* For elecronic LLDs, does the turbine automatically shut off if any porion of the monitoring system malfunctions �f N/A or fails a test? 11 ❑ Yes ❑ o* For electronic LLDs, have all accessible wiring connections been visuzUy inspected? I ZI N/A Ur 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 will be corrected. H. Comments: Page 3 of 3 03101