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F. In -Tank Gauging / SI Equi nt: Check this box if tan ging is used only for inventory control. <br />❑ Check this box if no tank gauging or SITZ equipment is installed. <br />This section must be completed if in -tank gauging equipment is used to perforin leak detection monitoring. <br />ComnWe the followinpr checkl®ct- <br />❑ Yes <br />❑ No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />❑ Yes <br />❑ No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />❑ Yes <br />❑ No* <br />Was accuracy of system product level readings tested? <br />❑ Yes <br />❑ No* <br />Was accuracy of system water level readings tested? <br />❑ Yes <br />❑ No* <br />Were all probes reinstalled properly? <br />❑ Yes....1 <br />,b a_ L._ _ <br />❑ No* <br />-..a _ __ a <br />I Were all items on the equipment manufacturer's maintenance checklist completed? <br />:....,+. vwa.v■■ Bn� ­xww, —a— ■uv uuw anu wnen tnese uencienrles were or will De Corrected. <br />G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />Comnlete the followinxr checklict- <br />0 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: 0` 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 />❑ 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 />U-NiX <br />❑ Yes <br />❑ Noy„ <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />f_ N/A <br />or disconnected? <br />❑ Yes <br />❑For <br />Z <br />electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br />or fails a test? <br />❑ Yes .. <br />❑""' <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />❑"' 1N/A <br />0 Yes <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />-_. -..- --�• -•• __� ......... ... ....vc ..vw auu wnvu cuvac unit u`vinam were or wnl De corrected. <br />H. Comments: <br />Page 3 of 3 03101 <br />