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F. In-Tank Cauginn 1 SIR Equipment: ❑ Check this box if tank_auging is used only for inventory control. <br /> ® Check this box if no tank gauging or S1R equipment is installed. <br /> This saetion must be completed if in-tank gauging equipment is used to perform leak detection monitoring. <br /> Compute the follm%ing cltcel.list. <br /> ® Yes ❑ NO 1 las all input N�iring been inspected for-I)roper entry;3iii termination, including testing fur ground t':tults? <br /> ® Yes ❑ No* Were all tank gauging probes visually inspcctcd for damage and residue buildup? <br /> ® Yes ❑ NO Wa,accuse% of system product level readings tested`, <br /> LYe® Yes ❑ No l'e'as uccurtc\ of system waivr level readings tested? <br /> ❑ No* W'erc all pr.>hes reinstalled properly?❑ No* 4t'ere:ell items ort€he egtEipnlent mant&I turer's mail}tcnas,ce checklist completed`? MAY 4 4 2016 <br /> x In the Section 11, beioN%,dvscr•ibe ho,v anrt H hen these dcl'lciencies were or will be corrected. <br /> G. Line Leal: Decdors (LLD): ❑ Check this box if LLDs are not installed. <br /> Com pletr the 1'od0w'Ll'u.Checklist: <br /> Sl Yes ❑ No* For equil>:nritt sutra up or annual e luilfnten( certitik:aliun, was a leak simulated to verily LLD pertbrmance'? <br /> ❑ N �� tC'11e� ud;/regi a/)i) ) Simulated leak mte: M3 _,.p,h,: ❑ 0.I g.p.h ; ❑0.^ g.p.h. <br /> ® Yes ❑ NO all L.1.D) confirmed operational mtd accurate �ti 4hin regulatory requiremems? <br /> ® Yes ❑ No* %Vas the testing apparatus properly calibrated? <br /> ® Yes 3 No, m,chanical t_1 Ds, does the LLD restrict product flow if it detects a leak? <br /> (3/24) ❑ N/:a <br /> ❑ Yes ❑ M.* ' „el.ctrunic LI.Ds,does the turbine automatically shut off ifthe LLD detects a leak'? <br /> Nl <br /> ❑ Yes ❑ No, i-or ekctruni,: L IMs, does the turbine <<utomaticali� ,Iiut oft'it•anN portion of the monitoring system is disabled <br /> I'ElYes ❑ No* i ar electronic 1-1,13s. does the turbiuc autvmatically shut off if any portion of the monitoring system <br /> 3 N ,1 tt;;llitilctions or fails a test? <br /> ❑ Yes L Noy` 1 1=or electronic H.Ds, have all accessible wiring connections been visually inspected? <br /> I_ <br /> ❑ Yes ❑ N�.' 1I esc ul] itvnts on the equipment tuanulat:turer's rnaintenwin a checklist completed? <br /> * <br /> In tilt•Section 11�bciu:s, Litscribc. ho%► and is hen these deficiencies weer or 4s ill he corrected. <br /> H. Comments: 07 l.li 2000 FAILED TO STEP UP TO HIGH FLOW DURING TEST. <br /> 3118- $7 LD <br /> 3/24- 87 LD 7'Ey' 1,:Ii W/ INSPECTOR, PASSED. <br /> Monitoring C;mitic:;tion 1 est ltcpurt <br /> 3 of 4 <br />