COMPLIANCE INFO_1986-2005 - Laserfiche WebLink

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n1on0e,rfng System Certification Site Address: &P:� Y �---, inh - c ��../"1v _. Date of'I'esting/Servicing: F. In -Tank Gauging/ SIR Equipment: peck this box if tank gauging is used only for inventory control. ❑ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. Com cheeldist: u 1 c5 u NO vrcic an iaorc gauging prones visually inspecteu for aamage and residue buildup? ❑ Yes ❑ No* Was accuracy of system product level readings tested? ❑ Yes ' ❑ No* Was accuracy of system water level readings tested? ❑ Yes ❑ No* Were all probes reinstalled properly? ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? d i— a ••• .•.- —•......•, uI —, u..�z c uUW auu wuuu louse ueliciencies were or will DC correctea. G. Line Leak Detectors (LLD): 0—CTiec-k this box if LLDs are not installed. Complete the following checklist: ❑ Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? ❑ N/A (Check all that apply) Simulated leak rate: ❑ 3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. ❑ Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? ❑ Yes ❑ No* Was the testing apparatus properly calibrated? ❑ Yes ❑ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ❑ N/A ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ❑ N/A ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled ❑ N/A or disconnected? ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system ❑ N/A malfunctions or fails a test? ❑ Yes ❑ No* For electronic LLDs, have all accessible wiring connections been visually inspected? ❑ N/A ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? __, ,,,,, ,,,,,,,,, ,,,,, ,,,, ,, aaeI."M Ga evct c UAWlll UC currecteu. H. Comments: