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A <br />F. In -Tank Gauging/ SIR EAment: <br />21`-�eckthis box iftan9l uging 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 />Cmmnletp thn fnllnwina ehrrkliet- <br />❑ Yes <br />❑ No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />❑ Yes <br />❑ No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />LJ Yes Yes <br />❑ No* <br />Was accuracy of system product level readings tested? - <br />❑ Yes <br />❑ No* <br />Was accuracy of system water level readings tested? <br />❑ Yes <br />❑ No* <br />Were all probes reinstalled properly? <br />❑ Yes <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />. .1 •••1 •••••••• __, ••1••••n .."• naw nuu wueu u,ese uenciencies were or win oe correctea. <br />G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />Complete the following checklist: <br />Yes <br />❑ No* <br />❑ N/A <br />For equipment start-up or annual equipment certi��fic tion,gleakulated to verify LLD performance?- <br />(Check all that apply) Simulated leak rate: �.p.h.; ❑ 2g.p.h.Yes <br />❑ No* <br />Were all LLDs confirmed operational and accurate within' rements?❑ <br />No* <br />Was the testing apparatusproperly calibrated? <br />Yes <br />❑ No* <br />❑ N/A <br />For mechanical LLDs, does the LLD restrict product flow i? <br />❑ Yes <br />❑ * <br />L1 N/A <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />❑ Yes <br />❑ �fc <br />- <br />N/A <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is dis abled <br />or disconnected? <br />❑ Yes <br />❑ No* <br />Pf N/A <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring. system <br />malfunctions or fails a test? <br />❑ Yes <br />Ll >W <br />EY N/A <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />Yes <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />- iu we occuun n, ucmw, ueacrme now app wnen tnese aenclencles were or will be corrected. <br />H. Comments: <br />Page 3 of 3 <br />03101 <br />