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r yr in rLuum r"QL U <br /> L ��/ � <br /> F. In-Tank Gauging I SIR Equipment: !Lr Check this box if tank gauging is used only for inventory control. <br /> ❑ Check this box if no tank 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 /> Com tete the followinp checklist: <br /> Yes ❑ No` Has all input wiring been inspected for proper entry and termination, including testing for ground faults'? <br /> es ❑ No* W ere all tank gauging probes visually inspected for damage and residue buildup? <br /> Yes ❑—Ne was accuracy of system product level readings tested? <br /> es ❑ No* Was accuracy of system water level readings tested? <br /> es ❑ No" Were all probes reinstalled properly? <br /> es ❑ 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): ❑ Check this box if LLDs are not installed, <br /> Complete the followinj checklist: <br /> Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD perfomunce7 <br /> ❑ N/A (Check all that apply) Simulated leak rate: 211 g.p.h.; ❑ 0.1 g.p.h; Cl 0.2 g.p.h. <br /> JW Yes ❑ No" Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> 91 Yes ❑ No- Was the testing apparatus properly calibrated? <br /> Rf Ycs ❑ No" For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> ❑ N/A <br /> ❑ Yes Cl No' For electronic LLDs,does the turbine automatically shut off if the LLD detects a icak? <br /> eN/A <br /> ❑ Yes ❑ No' For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> WNIA or disconnected'? <br /> ❑ Yes ❑ No' For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfimctions <br /> XN/A or fails a test'? <br /> Cl Yes ❑ No" For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> 5rN/A <br /> Yes ❑ No' Were all iterns on the equipment manufacturer's maintenance checklist completed? <br /> In the Section H,below,describe hose and when these deficiencies were or will be corrected. <br /> H. Comments: <br /> Page 3 of 3 ovo r <br />