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F. In -Tank Gauging / SIR Equi a t: <br />Check this box if tank uging 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 thwfollowih checklist: <br />❑ Yes <br />❑ No* <br />I 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 ❑No* Were all items on the equipment manufacturer's maintenance checklist completed? <br />All 4,11%; cm.-tRu" KA, "Clow, dCNCFIK a now and when Tnese deficiencies were or will be corrected. <br />Completethe following checklist: <br />❑ Check this box if LLDs are not installed. <br />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: ff3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />K3 Yes <br />❑ No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Yes <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 />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />a 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 />4 N/A <br />or disconnected? <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br />9Q N/A <br />or fails a test? <br />❑ Yes <br />❑ No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />A N/A I <br />- <br />JM. Yes <br />❑ No* I <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* Tw bi. <br />iF <br />J_e__­ _ A _ . ... a. <br />aae .aa., va,a .Xun AA, 6Ji7JV W, <br />H. Comments: <br />lin;nuw and when These ldenclencies were or will be corrected. <br />Mage 3 of 3 03101 <br />