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F. In` -Tank Gauging I SIR Equipment: ® Check this box if tank ga g is used only for irk o <br />El Check this box if no tank gauging or SIR eq is i toEIVEL) <br />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. 1 <br />Complete the following checklist: NOV U 2 2015 <br />❑ <br />Yes <br />❑ <br />No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />❑ <br />Yes <br />❑ <br />No* <br />Were all tank gauging probes visually inspected for damage and residue buildup?J1 -41vi- <br />n ❑Tll � <br />❑ <br />Yes <br />❑ <br />No* <br />Was accuracy of system product level readings tested? <br />❑ <br />Yes <br />❑ <br />No* <br />Was accuracy of system water level readings tested? <br />❑ <br />Yes <br />❑ <br />No* <br />Were all probes reinstalled properly? <br />❑ <br />Yes <br />❑ <br />No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />- In section H, below, describe now and when these deticiencies were or will be corrected. <br />Line Leak Detectors (LLD): ® Check this box if LLDs are not installed. <br />Complete the followina checklist: <br />❑ <br />Yes <br />❑ <br />No* <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) <br />® <br />N/A <br />Simulated leak rate: ❑ 3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />❑ <br />Yes <br />❑ <br />No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />❑ <br />Yes <br />❑ <br />No* <br />Was the testing apparatus properly calibrated? <br />❑ <br />Yes <br />❑ <br />No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />® <br />N/A <br />❑ <br />Yes <br />❑ <br />No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />® <br />N/A <br />❑ <br />Yes <br />❑ <br />No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br />® <br />N/A <br />❑ <br />Yes <br />❑ <br />No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? <br />® <br />N/A <br />❑ <br />Yes <br />❑ <br />No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />® <br />N/A <br />❑ <br />Yes <br />® <br />No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />to section H, Delow, descrlDe now and wnen these aeticlencles were or wm De corrected. <br />H. Comments: SUCTION LINE WITH POSITIVE SHUTDOWN <br />AL <br />IT <br />Monitoring System Certification Page 3 of 4 2/21/07 <br />