COMPLIANCE INFO_1998 -2011 - Laserfiche WebLink

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F. In -Tank Gauging / SIR Equipment: ® Check this box if tank gauging is used only for inventory control. ❑ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. Comnlete the following checklist: ❑ Yes ❑ No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? ❑ Yes ❑ No* Were all tank -gauging probes visually inspected for damage and residue buildup? ❑ Yes ❑ No* Was accuracy of system product level readings tested? ❑ Yes ❑ No* Was accuracy of system water level readings tested? ❑ Yes ❑ No* Were all probes reinstalled properly? ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? - to the Jectlon H, neiow, aescrine now ana when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): Comnlete the following checklist: ❑ Check this box if LLDs are not installed. ® Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? Serial Number ❑N/A Check all that apply) Simulated leak rate: ®3 .h. [10. 1 .h ; [:10.2 .h. ❑ Yes ® No* Were all LLDs confirmed operational and accurate within regulatory requirements? ® Yes ❑ No* Was the testing apparatus properly calibrated? ® Yes ❑ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ❑ N/A LD -2000 El Yes Ll No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? DIESEL (SOUTH) ® N/A 7011359 ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled ® N/A or disconnected? ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system ® N/A malfunctions or fails a test? ❑ Yes ❑ No* For electronic LLDs, have all accessible wiring connections been visually inspected? ® N/A ® Yes ❑ No* _ I 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. H. Comments: LD Product Grade Model Serial Number Pass/Fail 1 DIESEL (NORTH) FX -IV 1408 FAL`: 2 DIESEL (SOUTH) FX -IV 9574 FAIL* DIESEL (NORTH) LD -2000 7011360 PASS DIESEL (SOUTH) LD -2000 7011359 PASS -- BOTH NORTH AND SOUTH LEAK DETECTORS WERE REPLACED Page 3 of 3 Monitoring System Certification