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is <br />In -Tank an ang / E quip ent® Check this box if tank gauging is used Only for inventory control. <br />❑ 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 />t:oen tete the to61owi, a, checklist: <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />❑ <br />❑ <br />❑ <br />No* <br />No* <br />No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />Was accuracy of system product level readings tested? <br />E3 Yes <br />❑ <br />No* <br />Was accuracy of system water level readings tested? <br />❑ Yes <br />jL3 <br />gNo*WereHallitreoms <br />es reinstalled properly? <br />❑ Yes <br />* In the Seetinn ESI_ <br />Wereon the equipment manufacturer's maintenance checklist completed? <br />hevlaw A --h- sin m.1 ..P, <br />__._ ....w...,.� ,, . e—v.,w,ca wma r ur wm aye correc¢eae. <br />G. Line Leak Detectors (LLD): heck this box if LLDs are not installed. <br />I., <br />Complete the following checklist:-�- <br />❑ Yes ❑ No* For equipment start-up or annual equipnYent certification, was a leak simulated to verify LLD performance? <br />❑ N/A (Check all that apply) Simulated leak rate: ❑ 3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />❑ Yes <br />❑ No* <br />I Were all LLDs confirmed operational and accurate within regulatory requirements? <br />❑ Yes <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />❑ Yes <br />❑ No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />❑ N/A <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />❑ N/A <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />❑ N/A <br />or disconnected? <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br />❑ N/A <br />or fails a test? <br />❑ Yes ❑ No* I For electronic LLDs, have all accessible wiring connections been visually inspected? <br />❑ N/A <br />LlYes LlNo* Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In the Section II, belaw, describe how and when these deficiencies were or will be corrected. <br />H. Comments: <br />Nage 3 of 3 03/01 <br />