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F. In-'fa;ji Gnuging / SIR Equiolent: A Check this box if tan <br />i0ging is used only for inveiitory cGgjtyol. <br />L3 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 />COMDlete the followins! checklist: <br />Ll Yes <br />Q <br />No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />LJ Yes <br />U <br />No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />LJ Yes <br />Ll <br />No* <br />Was accuracy of system product level readings tested? <br />Ll Yes <br />13 <br />No* <br />Was accuracy of system water level readings tested? <br />LJ Yes <br />U <br />No* <br />Were all probes reinstalled properly? <br />LJ Yes <br />Ll <br />No* . <br />­ Were all items on the equipment manufacturer's maintenance checklist completed? <br />ANA &Ax%; ve.a.&A­A Am, ­A"VV, wcaax vc usvero n1ju W11VIl LAMUOU UUJ1U1CH%;1tZwore or will De correcrea. <br />G. Line Leak Detectors (LLD): E3 Check this box if LLDs are not installed. <br />ComDlete the following checklist: <br />Yes <br />,kl Yes <br />- <br />U No* <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br />Ll N/A <br />(Check all that apply) Simulated leak rate: 93 g.p.h.; P0.1 g.p.h ; L30.2 g.p.h. <br />)!Sk Yes <br />L3 No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Yeses <br />es <br />0 No* <br />Was the testing apparatus properly calibrated? <br />A <br />Ll No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />-Yes <br />Ll N/A <br />L3 Yes <br />Ll No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />J-9, N/A <br />L3 Yes <br />0 No* <br />For electronic LLDs, does the turbine automatically shut off- if any portion of the monitoring system is disabled <br />,R,L N/A <br />or disconnected? <br />L3 Yes <br />13 No* <br />For, electronic LLDs, does the turbine automatically shut off, if any portion of the monitoring system malfunctions <br />I& N/A <br />or fails a test? <br />0 Yes <br />No* <br />For electronic LLDs, haveI all accessible wiring connections been visually inspected? <br />[2 <br />LYe <br />N/A <br />Yes I <br />U No* . <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />in ine nection n, ociow, aescrioe now and when these clenciencies were or will be corrected. <br />H. Comments: <br />Page 3 of 3 03101 <br />