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06 / 28 / 2019 19 : 29 8387674 EMILS PAGE 13 <br /> F in-Tank Gauging / SIR Equipment: ® Check this box if tank gauging le 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 I,.I gauging equipment is used to padOrm leak dejection monitoring. <br /> Complete the following checkGsr. <br /> ® Yes ❑ Now Nes all Input wiring been Inspected for proper entry and termination, including testing for ground feuHs? <br /> Yes ❑ No Were all tank gauging probes visually inspected for damage and residue buildup? <br /> ® Yes ❑ No' Was accuracy of system product level readings tested? <br /> Yes ❑ Now Was accuracy of System water leve! readings tested? <br /> Yes ❑ Now Were all probes relnstalied property? <br /> III WIN <br /> Yes ❑ No' Were all items on the equipment manuluoureea maintenance ehacWistcompleted? <br /> In seclton M. below, describe how and when these deFiclencle$ were or will be corrected. <br /> Line Leak DeteI (LLD): ❑ Check this box if LLD% are not installed. <br /> Com fete the fOltOWin oheckliisf <br /> Yes ❑ N=111o' For equipment start-up or annual egUlpmenl CenlficaiionI was a leak simulated to verify LLD perfonnanCe? (Check alt that r DplY) <br /> ❑ NIA simulated leak rate: 3 9-Ph - ; ❑ 0. 1 gMEN .p.h : ❑ 0.2 g•p• h • <br /> WIN <br /> 9 Yea ❑ Now Were all LLconfirmed operational and accufete wIIII <br /> ithin regulatory requlremente? <br /> Ds <br /> Yee ❑ <br /> No Wes the testing aDperalua property calibrated? <br /> �j Yes [] Now For mechanical LLDs. does the LLD restrict product flow if it detects a leak? <br /> ❑ WA <br /> ❑ Ye, Q No' For electronic LII does the turbine qutomellully shut ott if the LLD detects a leak? <br /> NIA <br /> C] <br /> as ❑ Now For electronic LLDdisabled or disoonn <br /> s. does the turbine automatically shut off if any portion of lite monitoring system is <br /> NIA <br /> [] Yes (J Now For electronic LLDs, does the turbine sutomaticslty =hut off if any portion of the monitoring system mgifunctiona or falls a test? <br /> 11 <br /> NIqF hill 11 III <br /> J ❑ Yes O No For eiedronlc LLDs, have all accessible wiring connectiom been vteuaUy Inopacled' <br /> ® wn <br /> (� Yes p Now Were all items on ilia equipment manufactures mi intenence checklist completed? <br /> ' In section H, below, descrI how and wfien thane deficiencles were or will be corrected. <br /> H , CdnlmBnla : N <br /> Received Time Jun , 28 . 2019 7127PM No . 5223 <br />