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F. In-Tank Gaugiug f SIR Egi�nent: �i t'Beck this box if t auging is used only For inventory control. <br /> U Check this box i V no iank 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 /> 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 gatiging probes visually inspected For damage and residue buildup? <br /> ❑ Yes ❑ No* Was accuracy of system product level readings tested? <br /> Q Yes ❑ No* Was accuracy of system water level readings tested? <br /> ❑ Yes © No* Were all probes reinstalled properly? <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 /> G. Line Leak Detectors (LLD): U (`h(-(;k this box it'I.IA)s are not installed. <br /> Coqkplete the fallowing checklist: <br /> Uf Yes 0 No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br /> ❑ N/A (Check all that apply) Simulated leak rate. R 3 g.p.h.; ❑ 0.1 g.p.h; ❑ 0.2 g.p.h. <br /> Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirettrents7 <br /> Y s O 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 /> ❑ NIA <br /> ❑ yes ❑ * For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> C NIA <br /> ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> ffN/Aor disconnected? <br /> El yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system <br /> d'N/A malfunctions or fails a test? <br /> U Yes ❑ No* Far electronic LLDs, have all accessible wiring connections been visually inspected? <br /> O N/A <br /> Q Yes O No Were all items on the equipment iimanufacturer's maintenance checklist completed? <br /> L <br /> *In the Section H, below,describe how and when these de.licieneics were or will be corrected. <br /> H. Comments: <br /> Page 3 of 3 03101 <br />