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0 <br />F. In -Tank Gauging / SIR Equipment <br />• <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 />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. <br />Copipiete the Pollowin¢ checklist: <br />-- <br />es <br />— <br />❑ <br />..- <br />No* <br />.� _ •uY�• . fi uccn uuucc,eu for oroper entry and tertmnation, including testing for ground fauhs? <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />es <br />❑ <br />NO <br />Was accuracy of system product level readings tested? <br />RK13—Z <br />❑ Yes <br />❑ Flo* <br />Was accuracy of system water level readings tested? <br />❑ Yes <br />FIK�' No* <br />❑ /A <br />For electronic LLD9, does the turbine automatically shut off if the LID detects a leas'^: <br />Were all probes reinstalled properly'? <br />Yes No* Were all items on the equipment manufacturer's maintenance cbeckiist completed? <br />* to the Carp,... u u.a.,.., a --- ..:t... U_....._., <br />G. Line Leak Detectors (LLD): <br />Complete the Pollowino clrerkfist- <br />•+.. <br />❑ Chuck nils box if LLDs are not installed. <br />Yes <br />❑ No* <br />❑ N/A <br />For equipment start -m or annual equipment cc ficadon, was a leak simulated to verify LLD performance? <br />(Check all that apply) Simulated leak rare: ,3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />❑ <br />No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Yes <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />❑ Yes <br />❑ Flo* <br />For mechanical LLDs, does the LLD restrict product flow if it detects aleak? <br />❑ Yes <br />FIK�' No* <br />❑ /A <br />For electronic LLD9, does the turbine automatically shut off if the LID detects a leas'^: <br />❑ Yes <br />No* <br />❑ /A <br />For electronic LUX does the turbine automatically shot off if any portion of the monitoring system is disabled <br />or disc ected? <br />❑ Yes <br />Or NO <br />❑ N/A <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system maffim dons <br />or fails a test? <br />Yes <br />❑ No* <br />❑ N/A <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />El Yes <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />in rte zecaon n, wow, nesmbe bow and when these deticiencies were or will be corrected. <br />A. Comments: D r et c>L L.0 -3 0 <br />97 za:nA Ct ( ko I'aS'S'fa <br />Page 3 of 3 <br />U3/O1 <br />