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HEG,t[ I E U <br /> F.In-Tank Gauging/SIR Equipment: <br /> N Check this box if tank gauging is used only for inventory contrMAR 15 2016 <br /> El Check this box if no tank gauging or SIR equipment is installed. <br /> ENVIRONMENTAL <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. 7 A ®,P7,N <br /> Complete the follqw!ng,chccklisf: <br /> V...... ... ..... <br /> Yes 1 ❑No d F No Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> .iYes F-1 No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> ElYes [E:1 No* Was accuracy of system product level readings tested? <br /> MOM <br /> ❑Yes F-1 No* Was accuracy of system water level readings tested? <br /> ❑ 's ❑No* Were all probes reinstalled properly? <br /> ❑Yes ❑No* <br /> Were all items on the equipment manufacturer's maintenance checklist completed? <br /> *In the Section if,below,describe how and when these deficiencies were or will be corrected. <br /> G.Line Leak Detectors(LLD): FXJ Check this box if LLDs are not installed. <br /> Complete the following checklist: <br /> .................. <br /> F]Yes For equipment start-up or annual equipment certification.was a leak simulated to verify LLD per form an ce?(Ch eck <br /> .❑.... ......... <br /> F-13gp.h.; ❑E]0.1gp.h;E]0.2 g.p.h. <br /> F-1 N�A all that apply)Simulated I eak rate: <br /> ----------- <br /> E]NoWere all LLDs confirmed operational and accurate within regulatory atory requirements? <br /> E:1 Yes <br /> ........❑.. ............. ......... <br /> ........................ .........--.................................. <br /> 11 El Yes In'No* Was the testing apparatus properly calibrated? <br /> ............ —------.............. -----------------= <br /> ............... <br /> lFor mechanical LLDs,does the LLD rest ri ct product flow if it detects a leak9 <br /> El Yes M No <br /> El N/A <br /> .... ............... ................. . . ....... .................... t.......... ......... ......... <br /> ........... -------- <br /> El Yes ❑No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> F-1 N/A <br /> .. ....... <br /> 11 ❑Yes ❑No* For electronic LLDs, does the turbine automatically shut off i f any portion of the monitoring system is disable or <br /> 0 N/A <br /> disconnected? <br /> ............... <br /> Ei <br /> .............. ........... <br /> El Yes El No* Forelectronic LLDs,does the turbine automatically shut offif any portion of the monitoring system malfunctions or <br /> fai Is a test? <br /> Ej N/A <br /> ................ ...... ........ <br /> i� Ej Yes M No Forelectronic IJ,Ds,have all accessible wiring connections been visual ly inspected? <br /> ❑N/A <br /> Yes ❑No Were all items on the equipment manufacturer's maintenance checklist completed? <br /> ........ -------­1­1,� ......... <br /> In the Section K below,describe how and when these deficiencies were or wig be corrected. <br /> H. Comments: <br /> Suction System <br />