COMPLIANCE INFO 2002-2010 - Laserfiche WebLink

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lolonitcri.ng System Certification Site Address: "W1 llmw Date of Testing/Servicing: F. In-Tank Gauging/SIR Equipment: ❑ Check this box if tank gauging is used only for inventory control. Gdc�< this box if no tank gauging or SIR equipment is installed. This section mast be completed if in-tank gauging egUipment is used to perform leak detection monitoring. Complete the following cheelclist: ❑ 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 buildtrp? ❑ Yes ❑ No* Was accuracy of system product level readings tested? ❑ Yes ❑ No* Was accuracy of system water leve! readings tested? ❑ Yes C] No* Were all probes reinstalled properly? Yes �] No* Were all items on the equipment manufacturer's maintenance checklist completed? '" In the Section H, beloFv, dCSCD'IbC IY(}FV and {VIICIt tllC5e DICfiCIeDrC1eS WCr'e UI'will tae CUI'D'CCtL'd. G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. Complete the following checklist: Yes Ll No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? EJ N/A (Check all Haat apply) Simulated leak rate: F0"-g.p.h.; ❑ 0.1 g.p-ID ; ❑ 0.2 g.p.h. U-Yes ❑ No* Were all LLDs confinned operational and accurate within regulatory requirements? es ❑ 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 ❑ Yes ❑ No* For electronic LLDs, does the t N1A urbine automatically shut off if the LLD detects a leak? � ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled UN/A or disconnected? a Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system Cl`N/A malfunctions or fails a test? Yes Cl N.o* For electronic LLDs, have all accessible wiring connections been visually inspected? ❑CN/A 3"Yes ❑ No* 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. I. Comments: