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R P <br />F. In -Tarek Ganging / SIR EAnent: <br />0 <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 />KYesNo* <br />No* <br />Has all input wiring been inspected for proper entry and termination, including testing for groun7fi1U1tS? <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />No* <br />Was accuracy of system product level readings tested? <br />Yes <br />No* <br />Was accuracy of systemwater level readings tested? <br />❑ Yes <br />❑ No* <br />Were all probes reinstalled properly? <br />❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br />* Tn thn Q-+- U 1, 1- .1- :l... 1... - <br />- --- --- ---.. ...... •.-.�......,v d.eiealuluea wcic ur wu1 ve correciea. <br />G. Line Leak Detectors (LLD): Check this box if LLDs are not installed. <br />Complete the folinwinu checklist <br />Yes <br />❑ No* <br />For equipment start-up or annual equipmegcertification, was a leak simulated to verify LLD performance? <br />❑ N/A <br />(Check a// that apply) Simulated leak rate;�7 3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />Yes <br />❑ No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />es <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />Yes <br />❑ No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />❑ N/A <br />❑ Yes <br />❑ o* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />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 />N/A <br />or disconnected? <br />❑ Yes ' <br />❑ o* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system <br />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 />X <br />N/A <br />Yes <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />aF l.. 66.. c•....�t..� <br />as <br />�''_'. �_____'._ .. _ _ —_.. <br />___ ._.., ......,...�., aa9 v...v119 u..oa. - I pVt1 MAU wueu mese aencienc►es were or will be corrected. <br />H. comments: V o4 -p n + . +--f-��R <br />Page 3 of 3 03/01 <br />