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' 0 <br /> APR 19 2016 <br /> F.In-Tank Gauging/SIR Equipment: r Check this box if tank gauging is used only for inventory control. <br /> r Check this box if no tank gauging or SIR equi irpp ' I`rJ�� p�l�M <br /> ,'k VLK'r 'u .!L..-�.W. <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. j4.�1.14A(7WP4F4TVr-_i4 ' <br /> Complete the following checklist: <br /> Yes No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br /> + Yes No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> + Yes r No* Was accuracy of system product level readings tested? <br /> • Yes l" No* Was accuracy of system water level readings tested? <br /> « Yes r No* Were all probes reinstalled properly? <br /> �+ Yes No* Were all items on the equipment manufacturers 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): r Check this box if LLDs are not installed. <br /> Complete the following checklist: <br /> f* Yes C No* For equipment start-up or annual equipment certification was a leak simulated to verify LLD performance?(Check all that <br /> C N/A <br /> apply)Simulated leak rate:r 3 g.p.h.; r o,l g.p.h; r 0.2 g.p.h. <br /> �* Yes �` No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> + Yes ( No* Was the testing apparatus properly calibrated? <br /> Yes f No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> C* N/A <br /> + Yes r No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> N/A <br /> « Yes No* For electronic LLDs that are programmed for positive shut down,does the turbine automatically shut off if any portion of the <br /> monitoring system is disabled or disconnected? <br /> N/A <br /> + Yes r Na* For electronic LCDs that are programmed for positive shut down,does the turbine automatically shut off if any portion of the <br /> monitoring system malfunctions or fails a test? <br /> N/A <br /> • Yes r No* For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> C' N/A <br /> + Yes No* ere 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 12/07 <br />