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ii. j fi)oil? 4..i:�luyl'1Yl'tr (�7ll i9+.i +:9r�9]e .:51!1: C: Clr?iA (ILL; ie ta571. IU' II: C: L'::ri:l irlkh f4r <br />Ll Cl!ecl•. 0ii:•; 6wu it no hell; tiii: ccjui`r;n::nz i i�!:aullL' <br />I'iais scclion must hl: complctud if iii -tonne gauging equipment is used to perfor-in is tic dctcctiun Monitoriitr. <br />C:oIli nletc titer folleiwie> t CIRALliA; -- — _-- <br />U Yes O Nu° flas all input wiring been inn:pccted For proper entry and [crntination, inelutlin�4 tLsl.ng. For rground faedts? <br />❑ Yes U No; Werc all tank gauging prubes visually inspected for dam:iGo :Ind residue buildup? - <br />U 1`es ❑ Noy LVas accurucy ul'systu:n product level reading; tested? <br />❑ l'es O No* Was accuracy ofsystem water level readings tu%tcd? <br />U Ycr.; ❑ No" Were all prubes ntillstall0d properly? ------�-- <br />U Ye, 1 U Nn: I Were ull items on the equipment munufacturCT's maintenance checklist completed? <br />In the SAxtion H, below, describe how and when ihe:!e deficiencies wr_re or will he curree(cd. <br />G. Lime Leak TDetectan (I,LD): YCheck this box ii'UA)s are not installed, <br />if'mmnletC the fulluwille CIIeL' USt' <br />U Yes <br />U NO <br />Uor equipment start-up or annual cquipmunl ccrtilicudun, wa3 u leak simulated to veriFy LLD perrormancc? <br />0 N/A <br />(''heck u/l thul up/)[y) Simulated leak rate: ❑ 3 g.p.h.; ❑ 0.1 g.p.h -, ❑ 0.2 g.p.h. <br />(i Yrs <br />U No' <br />Were all LLI)s confirmed operutiunad aril accurate within rcguhdury ruquiromews? <br />❑ Yes <br />❑ NO <br />Was the testing appurutus properly calibrated? <br />❑ Yes <br />❑ NO <br />For mechanical LI -Ds, dues the W) restrict product flow if it detects a leak? <br />❑ N/A <br />U Yes <br />❑ No' <br />For electronic LLDs, dues the turbine automatically shut of lrtlte LLD detects a leak? <br />❑ N/A <br />_ <br />For electronic LI.Ds, dues the ttu•bbia autoutatically stutt off if any portion of the monitoring system is disabled <br />❑ Yes <br />❑ No" <br />❑ N/A <br />or disconnected? <br />U Yes <br />❑ No" <br />Fur cIcc—Ln inic LLDs, does the turbirte automatically shut off iF any portion of the monitoring system maltunctions <br />17 NIA <br />or tails a test? _ <br />❑ Yes <br />O No* <br />For electronic U..Ds, have all accessible wiring connections been visually inspectud'I <br />❑ N/A <br />❑ Yes <br />I U No* <br />Were all items on the equipment rnanufuclurer's maintenance checklist completed? <br />* In the Section H, below, QeserlbC now ane wnen uaese uencienciw were or wet oe correcreu. <br />11. comments:. <br />Page 3 of 3 01101 <br />2000 t -d3 TT:ZT 800Z/CT/OT <br />