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0 <br />% aL d& box if tank gauging is used Only for invCnt0ty contrO <br />F. In -Tank Gauging / SIR Equipment C1 Check this box if no tank gauging or SIEL equipment is inSW1Cd <br />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. <br />%,,UUA &_ . - .5- ...... ..... <br />0 Yes 0 N . Has alt input wiring been inspected for proper entry and termination, including testing for ground faults' <br />0 Yes N <br />0 o* Were all tank gauging probes visually inspected for damage and residue buildup? <br />Yes <br />J_ c <br />Q <br />No* <br />0 yes 0 No* was accuracy of system product level readings tested? <br />0 Yes .0 * was accuracy of system water level readings tested? <br />E3 Yes 0 No* Were all probes =WsMUed properly? <br />- El <br />0 yes #0 No* I Were all it= on the equipment manufacturcesmaintmmoe, checklist completed? <br />* in the Section � below, describe how and when these deficiencies were or will be corrected. <br />G. Line Leak Detectors (LLD): E3 Check this box if LLDs are not installed. <br />Mete the ponowing cneww: Z <br />: es 0 No* For equipment start-up or annual eqoipment��ation, was a leak simulated to verify <br />0 N/A I (Check all that apply) Simulated leak rate. 0 3 g.pJL; 0 0.1 gph ; 13 0.2 gp1L <br />MUMMM5 <br />zm= <br />amp= <br />� <br />a■Ez <br />Were, all LLD., c..&med operational and accurate within. regulatory reqmrements? <br />Was the testing appmtus propedy adibrated? <br />For mechanical LLDs, does the ILD restrict product flow it it detects a leak? <br />For electronic LLDs, does the turbine automatically - shut off if the LLD detects a leak? <br />perfo=anc <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is <br />or disconnected? ft monitoring System Md <br />For electronic LLDs, does the turbine automatically shut off if any portion of <br />or fails a test? <br />For electronic LLDs, have allaccessille vag connections beea,��inspccW? <br />nn <br />es 0 No* Were aIl items ctntireient wmnnicturees maintenance cnecJELin <br />deficiencies were or will b 1. corrected. the Section E� below, describe how and when <br />EL Comments. <br />8 <br />011CH <br />Page 3 of 3 <br />