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1'agc 3 of 3 <br />WI <br />U Chet this box ift,ui� gauging is used only for inventoryeonf[pl. <br />F. Lt=Cook Gaukink <br />/ SIR F,yuyuuclt11 <br />fox illus tank or SIR equipment is:in9fa"' <br />U t'hrek this gauging <br />be if in tank gauging equipment is used to perform leak detection monitioll[!g. r <br />This section joust <br />completed <br />wra.. <br />Complete the following checklist: <br />been mspecled for proper entry and termination, including testing for ground GulptT <br />No* <br />Has all input wiring <br />Were all lank gauging plohes visually inspected for (In and residue buildup? <br />❑ No* <br />❑ No• <br />Wes accuracy of syslent product level readings tested? <br />rO <br />❑ No* <br />Was accuracy of system water level readings tested'? <br />No• <br />Were all probes reinstalled properly?❑ <br />No* <br />Were all items on the equipment manufacturer's ntainlenance checklist completed? <br />* In the Section H, below, describe how and when Ihrse deficiencies were or will he corrected. <br />G. Line Leak Detectors (LLU) U t 'hry k this box it 1 1 .I is me not inslnllrJ. <br />Com tete the following checklist: _ <br />annual equipment certification, was a leak simulated to verify LLD pedonoaoeer' <br />ea ❑ No" <br />For equipment start-up or <br />PP Y) t d p.h.; ❑ 0. t g.p.h : ❑ 0.2 g.p.h. <br />(Check all that n i Simulated leak rale: <br />❑ N/A <br />❑ No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />yes <br />yes O No* <br />Was the testing apparatus properly calibrated? <br />O Yes ❑ No• <br />For mechanical LLDs, does the I.I.0 restrict product flow if it detects a Ieak7 <br />❑'N/A <br />❑ No* <br />For electronic LhUs, does the turbine automatically shut off if the hLU detects a leak? <br />es <br />1 <br />❑ N/A <br />shut off if any portion of the monitoring system is'disab <br />Ye70"—s ❑ No* <br />For electronic hLDs, does the tmhine automatically <br />❑ N/A <br />or disconnected? <br />LLlls, does the turbine aulomalically shut off if any portion of the monitOd4,syst m' <br />Yea ❑ No* <br />For electronic <br />❑ N/A <br />malfunctions or fails a test'? <br />LLDs, have all ni-rrssible wiring connections been visually inspected? <br />izrYes ❑ No* <br />For electronic <br />O N/A <br />O No« <br />Were all items on the equipment nnuntl'acntrcr's utnintenance checkiist completed? <br />Ya <br />* Ie the Section H, <br />below, describe how and when Ihese deftclencies were or will be corrected. <br />H. Comments: <br />-- — --- - -- <br />1'agc 3 of 3 <br />WI <br />