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F. In -Tank Gauging / SIR Equipment: Check this box if tank gauging is used only for inventory control. Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: I -- -"-----_�� ..I --••-••, ��•-••�� 19�.. ��.� r.l .�.. ulca Yes r Ir No* For equipment start-up or annual equipment certification was a leak simulated to verify LLD performance? (Check a// that apply) Simulated leak rate: V 3 g.p.h.; 0.1 g.p.h; 1Az' 0.2 g.p.h. Has all input wiring been inspected for proper entry and termination, including testing for ground faults? Yes Yes No* r No* ro Were all tank gauging probes visually inspected for damage and residue buildup? r Yes r No* Yes Was accuracy of system product level readings tested? r Yes For mechanical LLDs, does the LLD restrict product flow if it detects a leak? r No* Was accuracy of system water level readings tested? r Yes r r No* No* Were all probes reinstalled properly? i` Yes i" No* Were all items on the equipment manufacturer's maintenance checklist completed? * Tn fhn Cor+inn Whnl...., r4�Akl L,.... G uCiiI.ICIII.ICJ WCIC VI Wlil UC (:UT(CU.eU. G. Line Leak Detectors (LLD): rCheck this box if LLDs are not installed. Complete the following checklist: i+ _.. _.._ .., .,.,.,,.., ..w r N/A For equipment start-up or annual equipment certification was a leak simulated to verify LLD performance? (Check a// that apply) Simulated leak rate: V 3 g.p.h.; 0.1 g.p.h; 1Az' 0.2 g.p.h. G Yes r No* Were all LLDs confirmed operational and accurate within regulatory requirements? ro Yes r No* Was the testing apparatus properly calibrated? r# Yes r No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? N/A r Yes r No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? I N/A r Yes r No* N/A For electronic LLDs that are programmed for positive shut down, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? r Yes r r No* N/A For electronic LLDs that are programmed for positive shut down, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? r Yes r No* For electronic LLDs, have all accessible wiring connections been visually inspected? P N/A r'+ Yes No* Were all items on the equipment manufacturer's maintenance checklist completed? * Tn thn Qnr+;nn u kfll ^I AN A Comments: .. anu rvncn ulwc ucnucul.ICJ WCIC UI wm Ue correaea. Page 3 of 3 12/07