COMPLIANCE INFO_1987 - 2005 - Laserfiche WebLink

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i r F.' In-Tank Gauging/ SIR Equipment: ❑ Check this box if tank gauging is used only for inventory control. C�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. Com Tete the following checklist: ❑ Yes ❑ No* Has all input .viring been inspected for proper entry and termination, including testing for ground faults? ❑ Yes ❑ 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? * In the Section H, below, describe how and when these deficiencies were or«•ill be corrected. G. Line Leak Detectors (LLD): heck this box if LLDs are not installed. Cor: icte the folloNN g checklist: ❑ Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? ❑ N/A (Check all that apph) Simulated leak rate: ❑ 3 g.p.h.; ❑ 0.1 g.p.h . ❑ 0.2 g.p.h. ❑ Yes O No* Were all LLDs confirmed operational and accurate within regulatory requirements? ❑ Yes Cl No* Was the testing apparatus properly calibrated? ❑ Yes O No* For mech-=ical LLDs, does the LLD restrict product flow if it detects a leak? ❑ N/A ❑ Yes O 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? O Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system O N/A malfunctions or fails a test? ❑ Yes ❑ No* For electronic LLDs. have all accessible wiring connections been visually inspected? ❑ N/A O Yes 1 ❑ 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