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F.In-Tank Gauging/SIR Equipment: P 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 r No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> Yes r No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> Yes r No* Was accuracy of system product level readings tested? <br /> Yes r No* Was accuracy of system water level readings tested? <br /> Yes " No* ere all probes reinstalled properly? <br /> Yes r No* ere all items on the equipment manufacturer's maintenance checklist completed? , W <br /> *In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> G.Line Leak Detectors(LLD): r Check this box if LLDs are not installed. ENVIRONMENTAL HEALTH <br /> Complete the following checklist: DUARTMENT <br /> ro Yes r No* For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance?(Check all that <br /> N/A apply)Simulated leak rate:P 3 g.p.h.; 0.1 g.p.h; r 0.2 g.p.h. <br /> ro Yes r No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> ro Yes r. No* Was the testing apparatus properly calibrated? <br /> Yes No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> + N/A <br /> • Yes r No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> N/A <br /> • Yes r No* For electronic LLDs that are programmed for positive shut down,does the turbine automatically shut off if any portion of the <br /> r N/A monitoring system is disabled or disconnected? <br /> « Yes r No* For electronic LLDs that are programmed for positive shut down,does the turbine automatically shut off if any portion of the <br /> N/A monitoring system malfunctions or fails a test? <br /> • Yes r No* For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> N/A <br /> Yes No* Were 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 12/07 <br />