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F. In -Tank Gauging / SIR Equipment: <br />is <br />® Check this box if tank gauging is used only for inventory control. <br />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 />Complete the following checklist - <br />(des <br />:� es <br />❑ <br />❑ <br />No* <br />No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />(des <br />❑ <br />No* <br />Was accuracy of system product level readings tested? <br />(,'Yes —Ll <br />,a Yes <br />No* <br />Was accuracy of system water level readings tested? <br />..(i1 -Yes <br />❑ <br />No* <br />Were all probes reinstalled properly? <br />Yes' I ❑ <br />No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />in the SM10e11 n, Mow, aescnoe now and when these deficiencies were or will be corrected. <br />G. Line Leak Detectors (LLD): <br />Complete the following checklist: <br />( ) Check this box if LLDs are not installed. <br />.B --Yes <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: $3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />.ia"Yes <br />❑ No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />,a Yes <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />.0''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 />2' N/A <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system disabled <br />.0—N/A <br />:is <br />or disconnected? <br />❑ Yes <br />❑ No* <br />-N/A <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br />.Ur <br />or fails a test? <br />❑ Yes <br />❑ No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />.0 -N/A <br />es <br />* I <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />n the Section H, below, describe how and when these deficiencies were or will be corrected. <br />H. Comments: <br />Page 3 of 3 03101 <br />