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❑ 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 />LJ c� <br />Section <br />ami <br />El <br />El <br />rias au input wrong been inspected for proper entry and termination, including testing for ground faults? <br />❑ Yes <br />❑ <br />No` <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />❑ Yes <br />❑ <br />No' <br />Was accuracy of system product level readings tested? <br />El Yes <br />❑ <br />No' <br />Was accuracy of system water level readings tested? <br />❑ Yes <br />❑ <br />No. <br />Were all probes reinstalled properly? <br />❑ Yes El No- Were all items on the equipment manufacturer's maintenance checklist completed? <br />H, below, describe how and w n these defeiPnciac wPro nr will tie .. ,.. <br />IF] S he <br />ine Leak Detectors (LLD): <br />CmmnlPta the fnllnwin rha,w;c*. <br />In <br />❑ Check this box if LLDs are not installed. <br />® <br />Yes <br />El <br />El <br />No* <br />N/A <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) <br />Simulated leak rate: 0 3 g.p.h.; ❑ 0 t g,p.h ; El 0.2 g.p.h <br />® <br />Yes <br />❑ <br />No' <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />7 <br />Yes <br />❑ <br />No" <br />Was the testing apparatus properly calibrated? -- <br />® <br />Yes <br />El <br />No' <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />El <br />N/A <br />El <br />Yes <br />❑ <br />No' <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />® <br />N/A <br />❑ <br />Yes <br />❑ <br />No` <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br />® <br />N/A <br />❑ <br />Yes <br />❑ <br />No' <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? <br />® <br />N/A <br />❑ <br />Yes <br />❑ <br />No` <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />® <br />N/A <br />® <br />Yes <br />❑ <br />No' <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />ection H. helow. <br />dPscrihP <br />h- <br />v A u,i.un 1h..n...1 s:..:..__:__ <br />H_ Comments: <br />....,nitoring System Certification <br />Monitoring System Certification <br />Page 3 of 4 2/Z 1/0 7 <br />