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F. In -Tank Gauging I SIR Equipment: ,4 Check this box if tank gauging is used only for inventory control. <br />0 Cheek 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 />Comniete the foilowine checklist: <br />❑ Yes <br />0 No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />❑ Yes <br />0 No* <br />Were all rank gauging probes visually inspected for damage and residue buildup? <br />17 Yes <br />O No* <br />Was accuracy of system: product level readings tested? <br />0 Yes <br />la No* <br />Was accuracy of system water level readings tested? <br />0 Yes <br />❑ No* <br />Were all probes reinstalled properly? <br />❑ Yes <br />D No* <br />I Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In the Section H, below, describe how and when these deuciencies were or watt use correcttat. <br />G. Line Leak Detectors (LLD): O Check this box if LLDs are not installed. <br />Com fete the follo ing checklist. <br />Yes Q No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br />0 N/A (Check all that apply) Simulated leak: rate: YA g.p.h.; U 0.1 g.p.h : Q 0.2 g.p.h. <br />Yes 0 No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Yes <br />0 No* <br />I Was the testing apparatus properly calibrated? <br />Yes <br />0 No* <br />0 MA <br />f For mechanical L•LD% does the LLD -restrict product flow if it detects a leak? <br />U Yes <br />U No` <br />For electronic LLVs, does rite turbine automatically shut off if the l.i.D detects a leak? <br />O N/A <br />❑ Yes <br />0 No* <br />For electronic Lips, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />Q N(A <br />m disconnected? <br />❑ Yes <br />0 No* <br />For electronic LJ -Ds, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br />0 N/A <br />or fails a test? <br />❑ Yes <br />0 No* <br />For electronic LLDs. have all accessible wiring connections been visually inspected? <br />0 N/A <br />2 Yes 1 ❑ No* I Were all item on the equipment manufacturer's maintenance checklist completed? <br />* In the Section H, below, describe how and when these deMeacks were or will be corrected. <br />H. Comments: <br />Page 3 of 3 03/02 <br />