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0 <br />F. In -Tank Gauging / SIR Equipment: <br />0 <br />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 />n <br />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. <br />* In the Section r1, below, aescrrbe now ana wren mew uca•c,c-. — .,c.c �• �•� w <br />G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />7�77 ❑ No* For equipment smrt- p or annual equipment ce�rcadon, was a leak simulated to verify LLD performance? <br />❑ N/A (Check all that apply) Simulated leak rate: U 3 g.p.h.; ❑ 0.1 g.p.h; ❑ 0.2 g.p.h. <br />❑ No* Were all LLDs confumed operational and accurate within regulatory requirements) <br />Yes <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />Was the testing apparatus properly calibrated? <br />❑ Yes <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />Ryes <br />Yes <br />Was accuracy of system product level readings tested? <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />701N& <br />Was accuracy of system water level readings tested? <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />Yes <br />Were all probes reinstalled properly? <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />Yes <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In the Section r1, below, aescrrbe now ana wren mew uca•c,c-. — .,c.c �• �•� w <br />G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />7�77 ❑ No* For equipment smrt- p or annual equipment ce�rcadon, was a leak simulated to verify LLD performance? <br />❑ N/A (Check all that apply) Simulated leak rate: U 3 g.p.h.; ❑ 0.1 g.p.h; ❑ 0.2 g.p.h. <br />❑ No* Were all LLDs confumed operational and accurate within regulatory requirements) <br />Yes <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />❑ Yes <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />Yes <br />GI N/A <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />Yes <br />❑ N/A <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />n u,.w <br />.r a:......_..a...ewo <br />Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br />❑ N/A <br />or fails a test? <br />Yes <br />❑ No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />❑ N/A <br />Yes <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In the Section H, mow, aescnne now ana wnen mese ucaacnuo nc— — .. -• w ---• <br />H. Comments: <br />Page 3 of 3 03101 <br />