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III tUI Lltb :,y stein l,er Ut icatloit <br />0 Facility Name: Norms 7 ud1C of i csung,6crvwing: 11 / 4 /0 2 <br />F. In -Tank Gauging Equipment: <br />Q Check this box if tank gauging is used only for inventory control. <br />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. <br />Software Version Installed: 01 —1 1 <br />Complete the fnllnwina rharUliet- <br />HCl Yes <br />❑ <br />No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />Zi Yes <br />❑ <br />No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />i Yes <br />❑ <br />No* <br />Was accuracy of system product/waste level readings tested? <br />Xl Yes <br />❑ <br />No* <br />Was accuracy of system water level readings tested? <br />X] Yes <br />❑ <br />No* <br />Were all alarms activated and did they function <br />J.X] Yes 1 ❑ <br />No* <br />I Were all items on the equipment manufacturer's maintenance checklist completed? <br />-•• ........a,..aaasu aa, uu uvy, ueacl-hue 11— allu wren !nese ueuctencles were or will be corrected. , <br />G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />Comnlete the fnllnwina rhan4lic+• <br />Y] Yes <br />❑ No* <br />Was a leak simulated to verify LLD performance? (Check all that apply) <br />Simulated leak rate: [X3 g.p.h.; ❑ 0.1 g.p.h.; ❑ 0.2 g.p.h. <br />�1 Yes <br />❑ No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Yes <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />Xl Yes <br />❑ No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />❑ N/A <br />Q Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />CK N/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 />Ck 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 <br />CX N/A <br />malfunctions or fails a test? <br />❑ Yes <br />❑ No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />❑{ N/A <br />ID Yes <br />❑No* <br />I <br />If necessary to proper equipment operation, are fuel filters in good condition? <br />1:1N/ A <br />Yes <br />CI No* I <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />-•. •__� ua.a.aaa,aa =., ucww, Ueae, lire uuw anu wnen rnese aenctenctes were or will be corrected. <br />H. Comments: <br />CALINI-01 Page 3 06/23/99 <br />