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Site Address: EVAINk of Testing/Servicing: / <br />F. In -Tank Gauging / SIR Equipment: Check this box if tank gauging 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 the following checklist: <br />Yes <br />13 No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground: faults?.-..' _ <br />Yes <br />13 No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />Yes <br />[C3 <br />E3 No* <br />Was accuracy of system product level readings tested? <br />,,Yes;f� <br />' ❑'' No* <br />Was accuracy of system water level readings tested? <br />Yes <br />❑ No* <br />Were all probes reinstalled properly? <br />Yes CI No* <br />-A-i..`N.".. u <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />t.,.t.. .e.. <br />G.L Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />Complete the following checklist: <br />Yes <br />4 <br />For equipment start-up or annual equipment certification, was a leak simulated to verify' LLD perfprmance? <br />Yes <br />❑ No* <br />For equipment start-up or annual equipment certification, was a leak simulated to verify' LLD perfprmance? <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.� d ' <br />Yes ` <br />❑ No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? tr <br />Yes ` <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />❑ Yes <br />❑ * <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />lirN/A <br />k <br />es <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? r } <br />❑ NIA <br />, <br />es' <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system, �s disabled, <br />-- <br />❑ 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 <br />D N/A <br />malfunctions or fails a test? <br />Yes <br />❑ No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />U. Yes <br />No* I <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />in the erection rt, peiow, oescrine now ana when mese aeticiencies were or wilt be corrected. <br />H. Comments: <br />