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F. In -'Tank Gauging / SIR Equi nt: <br />Check this box if tank Aing 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 />Comnlete the fallawina cherk1ieW' <br />❑ Yes <br />❑ No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />❑ Yes <br />❑ No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />❑ Yes <br />❑ No* <br />Was accuracy of system product level readings tested? <br />❑ Yes <br />❑ No* <br />Was accuracy of system water level readings tested? <br />❑ Yes <br />No* <br />FU <br />Were all probes reinstalled properly? <br />❑ Yes No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />�--- ...-.. map ..o... I -----sw -"WT "MOU VTUVn LHV3V UCHI6:ICHIQ.IC9 wcrr or win ue correcrea. <br />G. Line Leak Detectors (LLD): <br />Comnlete the fnlinwina rherkHe+- <br />❑ Check this box if LLDs are not installed. <br />Yes <br />❑ No* <br />❑ N/A <br />For equipment start-up or annual equipment ification, was a leak simulated to verify LLD performance? <br />(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 />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Yes <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />❑ Yes <br />❑ * <br />N/A <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />Yes <br />❑ No* <br />❑ N/A <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />Yes <br />❑ No* <br />❑ N/A <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />or disconnected? <br />Yes <br />❑ No* <br />❑ N/A <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br />or fails a test? <br />Yes <br />❑ No* <br />❑ N/A <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />O.Yes <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />1I° C.IV OC%;Lluu Iz, uciow, uescrioe, now ana when rnese aenclencies were or will be corrected. <br />H. Comments: <br />Page 3 of 3 03101 <br />