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It <br />F. In -Tank Gauging/ SIR Equipment: <br />6 <br />c� Check this box if tank gauging is used only for inventory control <br />❑ Check this box if no tank gauging or SIR equipment is instaled. <br />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. <br />Complete the following checklist: <br />jl Yes <br />I <br />❑ <br />No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground CatJrs_� <br />Yes <br />❑ <br />No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? 1� <br />Yes <br />0 <br />No* <br />Was accuracy of system product level readings tested? <br />Yes <br />❑ <br />No* <br />Was accuracy of system water level readings tested? <br />�) Yes <br />❑ <br />No* <br />Were all probes reinstalled properly? <br />Yes <br />1 ❑ <br />No* <br />Were all items on the equipment manufacturer's maintenance checklist completed) <br />I In the Section H, below, describe how and when these deficiencies were or will be corrected. <br />G. Line Leak Detectors (LLD) <br />Comolete the following checklist: <br />❑ Check this box if LLDs are not installed. <br />I �SD 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: ,*3 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 />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 />❑ 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 or <br />❑ N/A <br />disconnected? <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br />❑ N/A <br />or fails a test? <br />❑ Yes <br />❑ No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected" <br />N/A <br />I' 1'es <br />❑ No* <br />rWee 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 be corrected. <br />H. Comments: <br />Page 3 of 3 <br />U3/U I <br />