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Aug, 16. 2004 10: 35AM No. 1413 P. 4 <br /> F. In-Tank Gauging/SIR �tipment: M Check this box if tafngauging is.used only for inventory control, <br /> 0 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 /> Complete the follo ing checklist: <br /> 0 Yes P'Ll ® Has allinputwining been inspected for proper entry and termination,including testing for ground—faults? <br /> 9 yes o No' eregauginggauging probes visually inspected for damage and residue TuiTdup. <br /> _ <br /> _ff y-es W-as accuracy of system product level readings tested? <br /> &-Yes 0 ® 7ii accuracy of system water leveI r"agg-s tisted? <br /> 0 Yes [3o Were all probes reinstalled properly? <br /> P N Y <br /> 0 1I Were all items on the equipment mane facturer's maintenance cleckTist completed? <br /> 119 URYYC'S'e ®Section H,below,desefifie low and when these deficiencies were or'WHI 5e sorra Red. <br /> G. Line Leak Detectors (LLD): 0 Check this box if LLDs are not installed. <br /> Com lets the_followin checklist: <br /> M Yes D ® For equipment start-up or annual equip-ment certification,was a leak simulated to verify LLD performance? <br /> 0 N/A (Check all that apply) Simulated leak rate: 13 3 g.p.h.; 11 0. 1 g.p.h. 0 0.2 g.p.h. <br /> 0 Yes 0 Now— Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> M Yes Q N6* Was the testing apparatus-properly calibrated? <br /> 0 yes M NO'F For meeRiRnieal LLDs,does the LLD restrict pro ruct flow if it detects a leak? <br /> 0 N/A UNLEADED MID FAMED TEST NEED TP REPLACE. <br /> 13 Yes Cl For electronic LLDs,does the turbine automatically shi-t-off it the LID detects a ReUl <br /> 0 N/A <br /> —yes -01-150-17- For electronic LLDs,does the turbine automatics rFy-shut 0 if any portion of the monitoring system is disable&- <br /> 0 N/A or disconnected? <br /> Ll Yes 0 N-01w- For electronic LLDs,does the turbine auto atica ly shut off if y portion of the monitoring system malfunctions <br /> 0 N/A or fails test? <br /> Yes <br /> 0 ® For electronic EDE,liave all accessible wiringconnectionsbeen_y1iRly_inspected? <br /> G N/A <br /> all items on the <br /> IL <br /> *Tn_5_eYect1ofi H,belW,21escri e S';;'and-when thes <br /> H. Comments: <br /> Page 3 of 4 03101 <br />