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�r <br />� F. In -Tank Gauginf; / S[R t�,quilr'nu•nf: <br />U Check this box if tank ganging is used only for inventory control. <br />U Check this box if* no tank gauging or SIR equipment is installed. <br />This section mast be completed if in --tank gmiging, cyuil-iment is used to perfitrm leak detection monitoring. <br />Complete the following checklist: <br />❑ Yes ❑ No* llas all input wiunf been inspected li,t propel e.ittIy and lei nrtnation, including testing for ground faults? <br />❑ Yes Cl No* Were all tank ganging ptohrs visually inspected lite damage and rrsidne buildup? <br />D Yes O No* Was accuracy of syslern produc t level readings tested' <br />D Yes O No* Was accuracy of system water level readings tested? <br />D Yes O No* Were all probes reinstalled properly? —� <br />O Yes O No* Were all items on the equipment manufacttner's maintenance checklist completed? <br />* In the Section H, below, describe how and when these deficiencies were or will be cot•rected. <br />G. Line Leak Detectors (1,1.1)): U ( lwc•k illi!, I)nx if 1,1.1)s aw not installed. <br />D Yes <br />U No* <br />Por cquipment start-up of annnat eoluipntent cc rtitication, was a Teak simulated to verify LLD performance? <br />O N/A <br />(Check all that apple) Simulated leak rate: f_l 3 g.p.h.; O 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />D Yes <br />O No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />D Yes <br />O No* <br />Was the testing apparatus properiy calibrated'? <br />D Yes <br />O No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />O N/A <br />_ <br />❑ Yes <br />O No* <br />For electronic LLDs, does the hnhine aulontatically shat off if the LLD detects a leak? <br />❑ N/A <br />U Yes <br />O No* <br />For electronic LLDs, docs the tmbioc automatically shut off ii'any portion of the monitoring system is disabled <br />' <br />O N/A <br />or disconnected? <br />Lj Yes <br />O No* <br />For electronic LLDs, docs the turbine aulontatically shut off if any portion of the monitoring system <br />O N/A <br />malfunctions or fails a test? <br />-- -- - - - -.—_ <br />For electronic LLDs, have all ac(.rssil)le wiring connections beets visually inspected? <br />O No* <br />LOYes <br />O N/A <br />Wereall items on the equipnuvnl rtcntlacntrer's maintenance checklist completed? <br />Yes <br />D No* <br />* in the Section H. <br />below, describe Trow and ei,lten these deficiencies were or will be corrected. <br />H. Comments: <br />Page 3 of 3 <br />03/01 <br />