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CEIVED <br /> F. In-Tank Gauging/SIR Equipment: 0 Check this box if tank gauging is used O)nl_ <br /> 0 Check this box if no tank gauging or SIR. UKITC1.9-Md" <br /> 'I'his section must be completed if in-tank gatiging equipment Is used to petltwimili�WAB*Atf H <br /> Complete the following checklist: )EPARTMENT <br /> FE- <br /> _ON o* Has all input wiringC_been inspected for proper entry and termination, includink testing Cor aground faults'Yes ­I­ Z� <br /> 0—yes C] No' Were all tank gauging probes visually inspected for damage and residue build:lp? <br /> Yes f- - <br /> I Noy` Wits accuracy of system product level readings tested? <br /> D—yes No* Was accuracy ofsystem water level readings tested? <br /> 0 Ts No* Were all probes reinstalled properly? <br /> Ch Ni)" Were all items on tlic equipment manufacturer's maintenance checklist completed? <br /> ................. <br /> In the Section H.below,describe[low and when these deficiencies were or will be corrected. <br /> C. Line Leak Detectors (LLD): 0 Check this box if 1.1,Ds tire not installed. <br /> Cont Bete the rollo ing checklist: <br /> 0 Yes No* For equipment start-up or annual equipment cer(ilication. was it leak simulated to verity LLD performance? <br /> 'irriulated leak rate: 0_1­�p.li- El 0. p -1 0,2 .P.1" 11. <br /> .3 N A wheckalithatappti-) 16,. .11; E <br /> 0 Yes C] No* 1k ere all U_Dsc�onfirrned operational and accurate within regulatory requirements? <br /> 1 0 Yes r <br /> No* Was the testing apparatus properly calibrated`? <br /> ................ <br /> 0 Yes 0 No" I-or mechanical IA.Ds,does the LLD restrict product flow if it detects a leak'.' <br /> 0 NA <br /> ............. <br /> 0 Yes 0 No* For electronic L.I..Ds,does the turbine automatically shut oft if the LLD detv.c s leak? <br /> 0 NA <br /> E Yes E, No* For electronic LIDs, does the turbine automatically shut off if any portion ol'the monitoring system is disabled <br /> r] N A or disconnected' <br /> 0 Yes 0 No* For electronic LL.Ds. does the turbine automatically shut off if an �)rtion of the monitoring system <br /> malfunctions or fails a test? <br /> 0 Yes ❑ Ne;; For electronic LLDs,have all accessible wirinu connections been visually i14� ected? <br /> N A ..........- <br /> tol i %ere all i <br /> in the Section 11,below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: TEST 87 I'LLD ONLY,91 IS A MECHANICAL <br /> Monitoring Certification Test Report <br /> Of4 <br />