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• *RECEIVED <br /> F. In-Tank Gauging/SIR Equipment: OCT 2 0 2014 <br /> Check this box if tank gauging is used only for inventory control. <br /> W Check this box if no tank gauging gt N0 rgµgypMNtA1!ed_EAUH <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoringDEPARTMENT <br /> Complete the following checklist: <br /> r Yes I No* I lab all input wiring heen inspected for proper entry and termination,including testing for ground faults? <br /> F )es F No Neie all tan6 auging probes u isuall} inspected foi damat;eall d ICI dIIC bwldUll •� <br /> ( <br /> Yes F No Was accuracy of system pioduU level readings tesled" <br /> F Yes F— No* Was accuracy of,y,tem watci level leading, tested? <br /> F )es F No* Were all probes reinstalled pioperk <br /> (— Yes '. F No* Were all items on the equipment manufactw ci's maintenance checklist completed? <br /> An the Section H,below,describe how and when these deficiencies were or pill he corrected. <br /> G.Line Leak Detectors(LLD): F Check this box if LLDs are not installed. <br /> Complete the follow ing checklist: <br /> 1 of equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance?(Check <br /> ((/ that apply) Simulated leak rate: r 3gp.h.; r 0.1 g.p.h; F 0.2g.p.h. <br /> F_ ) c; No` -Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> i Ycs No* '.Was the testing apparatus properly calibrated? <br /> is F Yes I No = '.I or mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> r N A <br /> Yes F No, For electronic LLDs. docs the turbine automatically shut off ifthe LLD detects a leak? <br /> Yes I Nc=t I ,,elccl ionic I I Ds, does the turbine automatically shut off ifany portion of the monitoring system is disabled or <br /> r N \ <br /> 11sconnccted7 <br /> r Yes r No' For electronic LLDs, does the turbine automatically shut off ifany portion of the monitoring system malfunctions or <br /> N;A 'fails a test? <br /> r Ycs \o* For elcctmnic ILD,, have all accessible wiring connections been visually inspected? <br /> F N A <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 ewrected. <br /> H. Comments: <br /> Suction System. <br />