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..�)•,IC 111 k'CI IlliCAi1011 <br />Facility Name: -_ _- -_..-- Norms_7.6 ___` ..J.11e of icsting,OCLNI'tng: _6/ <br />F. In -Tank Gauging Equipment: Cl Check this box if tank gauging is used only for inventory conn ()I <br />- This section must be completed if in -tank gauging equipment is used to perlonn leak detection monitoring. <br />Software Version Installed: 01-11 <br />Comnlete rh,• fnllnavinn nho lflict. <br />Yes <br />❑ <br />No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />Yes <br />❑ <br />No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />Yes <br />❑ <br />No* <br />Was accuracy of system product/waste level readings tested. <br />C1 Yes <br />❑ <br />No* <br />Was accuracy of system water level readings tested? <br />C[ Yes <br />I ❑ <br />No* I <br />Were all alarms activated and did they function properly? <br />Cl( YeLj. <br />❑ No* I <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />________ __, —,,,,,, ........,, ---- r.0 u,c--lulencles were or win De Corrected. <br />G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />Comnlete thr frill—i... ho tFn. #- <br />Yes <br />❑ \'o" <br />Was a leak simulated to verify LLD performance? (Check all than apply) �I <br />Simulated leak rate: 113 g.p.h.; ❑ 0.1 g.p.h.; ❑ 0.2 g.p.h. <br />Yes <br />❑ No* <br />Were all LLDs confumed operational and accurate within regulatory requirements? <br />CO Yes <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />❑ Yes <br />❑ No* <br />M N/A <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />❑ Yes <br />❑ No* <br />M N/A <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />❑ Yes <br />❑ No* <br />I$1 N/A <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />or disconnected? <br />❑ Yes <br />❑ No* <br />1 N/A <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring . system <br />malfunctions or fails a test? <br />C3 Yes <br />❑ No* <br />® N/A <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />❑ Yes <br />❑ Ni <br />H necessary to proper equipment operation, are fuel filters in good condition? <br />n <br />Q Yes <br />Cl No, <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In the Section H. <br />below. deserihe hnw and when thPcv <br />H. Comments: _Regular Gasoline line _-__leak detector failed to stay <br />in search position. <br />cAl.It-oi Page 3 <br />