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P Site Address: <br /> orresting <br /> F. In-Tarok Gauging/ SIR Equipment: CrClieck 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-lank gauging equipment is used to perform leak detection monitoring. <br /> Complete the following checklist: <br /> ❑ Yes ❑ENo <br /> * Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br /> ❑ Yes ❑ * Were all tank gauging probes visually inspected for damage and residue buildup? <br /> ❑ Yes ❑ * Was accuracy of system product level readings tested? <br /> ❑ Yes ❑ No* Was accuracy of system water level readings tested? <br /> ❑ Yes ❑ No* Were all probes reinstalled properly? <br /> ❑ Yes I ❑ No* i Were all items on the equipment manufacturer's maintenance checklist completed? <br /> * In the Section H, below,describe how and When these deficiencies were or will be corrected. <br /> G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br /> Complete the following checklist:Ef f <br /> Yes ❑ No* For equipment start-up or annual equipment c i ication, was a leak simulated to verify LLD performance? <br /> El N/A (Check all that apply) Simulated leak rate: C1`3 g,p.h.; 130.1 g.p.h , ❑ 0.2 g.p.h. <br /> Cf Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> Y El No* Was the testing apparatus properly calibrated? <br /> Yes ❑ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br /> ❑ N/A <br /> ❑ Yes ❑ NO For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br /> 0 N/A <br /> Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> 2i--'N—/A or disconnected? <br /> r(U <br /> Yes ❑ Talo* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system <br /> N/A malfunctions or fails a test?Yes ❑l No* For electronic LLDs, have all accessible wiring connections been visually inspected? <br /> U N/A <br /> Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> In the Section H, below,describe how and when these deficiencies Were or will be corrected. <br /> H. Comments: <br /> Page 3 of 3 D5�11(1 <br />