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REGLIVEL F. In -Tank Gauging / SIR Equipment: F' Check this box if tank gauging is used only for invent - r_1 016 r Check this box if no tank gauging or SIR equipment is i This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. ENVIRONMENTAL Complete the following checklist: rw Yes �: No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? G- Yes 01D No* Were all tank gauging probes visually inspected for damage and residue buildup? Yes �� No* Was accuracy of system product level readings tested? Gr Yes r No* Was accuracy of system water level readings tested? +' Yes r No* Were all probes reinstalled properly? + Yes No* ere all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): ri Check this box if LLDs are not installed. Complete the following checklist: (* Yes r No* For equipment start-up or annual equipment certification was a leak simulated to verify LLD performance? (Check all that apply) Simulated leak rate 3 g.p.h.; r! 0.1 g.p.h; i" 0.2 g.p.h. N/A Yes No* Were all LLDs confirmed operational and accurate within regulatory requirements? Yes No* Was the testing apparatus properly calibrated? i Yes IT No* For mechanical LLDs, does the LLD restrict product Flow if it detects a leak? 6 N/A ( Yes No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? N/A im Yes rV No* For electronic LLDs that are programmed for positive shut down, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? 001, N/A It YesI'P No* For electronic LLDs that are programmed for positive shut down, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? N/A Yes 0td1 No* For electronic LLDs, have all accessible wiring connections been visually inspected? ' N/A Yes r No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. Page 4 of 4 12/07