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t <br />F. In -Tank Gauging / SIR Equipa: t: <br />Check this box if tank go g 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 />Com fete the folio ;inchecklist: <br />Has input wiring been inspected for proper entry and termination, including testing for ground faults? <br />the following <br />Cl <br />❑ <br />No* <br />No* <br />all <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />FREE31 <br />❑ <br />No* <br />Was accuracy of system product level readings tested? <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Was the testing apparatus properly calibrated? <br />No* <br />Was accuracy of system water level readings tested? <br />L� —Ye s <br />❑ <br />No* <br />Were all probes reinstalled properly? <br />C� Yes <br />❑ <br />No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />❑ Yes <br />49 N/A <br />❑ No* <br />For electronic LLDs, does the turbine automa tically shut off if any portion of the monitoring system is disabled <br />.� a,.a,.:—Aar .vrrP nr will be corrected. <br />* In the Section n, aeiow, oescnvC u— 4..0 .._•-.. - - <br />G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />Complete <br />the following <br />checklist: <br />or annual equipment certification, was a leak simulated to verify LLD perfornnance? <br />J9 Yes <br />C3 No* <br />❑ NIA <br />For equipment start-up <br />(Check all that apply) Simulated leak rate: IR 3 g.p.h.; Cl 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Was the testing apparatus properly calibrated? <br />Yes <br />❑ No* <br />11 Yes <br />❑ No* <br />Yes <br />❑ No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />❑ Yes <br />❑ N/A <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />❑ Yes <br />49 N/A <br />❑ No* <br />For electronic LLDs, does the turbine automa tically shut off if any portion of the monitoring system is disabled <br />N/A <br />or disconnected? <br />LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br />❑ Yes <br />❑ No* <br />For electronic <br />51 N/A <br />or fails a test? <br />For LLDs, have all accessible wiring connections been visually inspected? <br />O Yes <br />❑ No* <br />electronic <br />IN N/A <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />Yes <br />❑ No* <br />* In the Section H, below, describe how and when these deficiencies were or will be corrected. <br />H. Comments: <br />03/01 <br />Page 3 of 3 <br />