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In -Tank Gstuging /SIR Etlutpntent: U Check this box if tank gauging is used only form,' Ifn ► <br />f U Cheek this box if no tank gauging or SIR egtdpixkiai <br />This section must be completed if in -tank gauging equilmtent is used to perform leak detection moni <br />Cotn late the following checklist: <br />O Yes O No* Has all input wiring been inspected for proper entry and termination, including testing for gromW Ak ?. <br />• Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? <br />• Yes O No* Was accuracy of system product level readings tested? <br />(3 Yes ❑ No* Was accuracy of system water level readings tested? <br />Cl Ycs ❑ No Were all probes reinstalled properly? <br />O Yes O No* 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 he corrected. <br />G. Line Leak Detectors (LLD): U t 'ht -A this box if 1.1.1)s nre not installed. <br />copajoete the folio Ing checklist: <br />Yea 1❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verity► <br />❑ N/A (Check all that apply) Simulated leak rate: B^ g.p.h.; ® 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />ydm is <br />Yes o* Were all LLDs confirmed operational and accurate within regulatory requirements? <br />ea ❑ No* Was the testing apparatus properly calibrated? <br />LD pm� <br />ea ' o* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />O N/A <br />Y ❑ No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />C1 Yes Q No* For electronic LLDs, does the hubine automatically shut off if any portion of the monitoring s <br />/A or disconnected? <br />Yes ❑ N * For electronic LLDs, does the turbine autoenatically shut off if any portion of the <br />A malfunctions or fails a test? <br />O Yea ❑ N * For electronic LLDs, have all accessible wiring connections been visually inspected? <br />Yes No* I Were all items on the equipment nnnnu acturcr s maintenance checklist comp a e <br />* In On Section H, below, describe how and when these deficiencies were or will be corrected. <br />H. Comments: V ®- -e 1 / 4o--- 7"�-' -e !�y. t nsf' gee <br />, <br />rO pit- Lif <br />11:1ge 3 of 3 <br />