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In-Tank Gauging I SIR Equipment: ❑ C �k 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 perfomi leak detection monitoring. Complete the following checldist: JF_U Yes . ❑ No* Has 0 input wiring been inspected forz,rooerentry and rl-7miration. inclUdina le-;ting for •.,l,r,,_l,,i�r` ❑ Yes ❑ No Were all tank:gauging probes visually inspected for d :_age and residue buildup? ❑ Yes El No* Was accuracy of system product level readings tested? 0 Yes ❑ No* Was accuracy of system water level readings tested? _ ❑ Yes ❑ No's Were all probes reinstalled properly? ❑ Yes ❑ Noy` Were all items on tLe equipment manufacturer's maintenance checklist completed? * In the Section H,below,describe how and when th -e deficiencies were or'w°ill be corrected. Check this box if LLDs are not installed. G. Line Leak Detectors (LLD): Com let e the foliowin checklist: Ll Yes ❑ No' For equipment start-up or annual equipment certification, was a leak simulated w Verify LLD performance? ❑ NIA (Check all that apply) Simulated leak rate: ❑3 g.p.h.; ❑ 0.1 g,p.h; ❑0.2 g.p.h. ❑ Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? Ll Yes ❑ No* Was the testing apparatus properly calibrated? ❑ Yes ❑ No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? ❑ NIA ❑ Yes D No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? NIA J Yes ❑ No* For electronic LLDs, dots the turbine automatically shut off if any portion of the IIaonitoring system is disabled ❑ NIA or disconnected? ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions ❑ NIA or fails a test? ❑ Yes 0 No* For electronic LLDs,have all accessible wiring connections been visually inspected? ❑ NIA ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H,below,describe how and when these deficiencies were or will be corrected. H. Comments: Page 3 of 3 03/01 f.