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F jn-Tank Gauging / SIR Equipment: <br />LPCfieck this box if tank gauging is used only for inventory control. <br />Ll -,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 />C:omvlete the following checklist: <br />Llys <br />❑ No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />M—Yes <br />❑ No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />Lames <br />❑ No* <br />Was accuracy of system product level readings tested? <br />Q -Tres <br />❑ No* <br />Was accuracy of system water level readings tested? <br />CI'�es <br />❑ No* <br />Were all probes reinstalled properly? <br />51 -Yes <br />❑ 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 deficiencies were or will be corrected. <br />G. Line Leak Detectors (LLD): <br />(—mato tha fnlinwina rhPeklict- <br />❑ Check this box if LLDs are not installed. <br />es <br />❑ No* <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br />❑ N/A <br />(Check all that apply) Simulated leak rate: Eff g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />❑ Yes <br />"o* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />EI -Yes <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />01 -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 />C -1/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 />U,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 />Cl --MA <br />or fails a test? <br />❑ Yes <br />❑ No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />es <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In the Section H, below, describe how and when these deficiencies were or will be corrected. <br />H. Comments: L <br />/-g e / <br />IM <br />Page 3 of 3 03/01 <br />