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rlr In rwtm rA1,;L 04 <br />F. U. -Tank Gauging ! SIR Equipment: .a Check this box if tank gauging is used only for inventory control. <br />O Check this box if no tank gau&g or SIR equipment is installed. <br />This section must be completed if in -tank gauging equipment is used to perforin leak detection monitoring. <br />Complete the following checklist: <br />W Yes <br />O No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults'? <br />Yes <br />O No* <br />Were all tank gauging probes visually'inspected for damage and residue buildup? <br />grYes <br />O No* <br />Was accuracy of system product level readings tested? <br />Yes <br />O No* <br />Was accuracy of system water level readings tested? <br />'z Yes <br />O No* <br />Were all probes reinstalled properly? <br />W Yes <br />O No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />" In the Section H, below, describe hoer and when these deficiencies were or will be corrected. <br />G. Line Leak Detectors (LLD): O Check this box if LLDs are not installed. <br />Complete the following checklists <br />!� Yes <br />O No* <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br />O N/A <br />(Check all that apply) Simulated leak rate: 03 g.p.h.; O 0.1 g.p.h ; C1 0.2 g.p.h. <br />Yes <br />O No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Yes <br />Q No* <br />Was the testing apparatus properly calibrated? <br />Ycs <br />O No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />O N/A <br />O Yes <br />O No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />N/A <br />O Yes <br />O No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />NIA <br />or disconnected? <br />O Yes <br />O NO <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br />N/A <br />or fails a test'? <br />O Yes <br />O No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />JX N/A <br />Yes <br />®No' <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />In the Section H, below, describe how and when these deficiencies were or will be corrected. <br />H. Comments: <br />Page 3 of 3 O-Ve t <br />