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F. in-Tank Gauging/SIR Equipment: a Check this box if tank gauging is used only for inventory control. <br /> -1 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 folio win 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 gauging probes visually inspected for damage and residue buildup? <br /> ❑ Yes ❑ No* Was accuracy of system product level readings tested? <br /> ❑ Yes ❑ No* Was accuracy of system water level readings tested? <br /> :3 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): ❑ Check this box if LLDs are not installed. <br /> Com tete the followin>checklist: <br /> Yes I ❑ No* For equipment start-up or annual equipment c!V­ication, was a leak simulated to verify LLD performance'? <br /> ❑ N/A (Check all that apply) Simulated leak rate: �IS g.p h.; ❑0.1 ,.p.h ; ❑0.2 g.p.h. <br /> Yes ❑ No* Were all LLDs consumed operational and accurate within regulatory requirements? <br /> Yes ❑ No* Was the testing apparatus properly calibrated'? <br /> Yes ❑ No* For mechanical LLDs,does the LLD restrict product t]ow if it detects a leak? <br /> ❑ N/A <br /> ❑ Yes :1 NN * For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> N/A <br /> ❑ Yes ❑ leo* For electronic LLDs.does the turbine automatically shut off if any portion of the monitoring system is disabled { <br /> r�N/A or disconnected? <br /> ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions <br /> �r7N/A or fails a test'? <br /> ❑ Yes ❑ * For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> N/A <br /> Yes ❑ No* Were ail 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 /> D. Comments: 7-Htr P2-em­<M --i/ <br /> -.Ze_' l�S �-4tz4&_ iti yl_�C E<_Tjz,c4 C sy5 <br /> Cti' 1 > 4-04-- Tc c K o ti i t f}rk.k <br /> L� t � T4�rrr,�y s FF Mot j�_CL4�! "IeC✓r, <br /> .4 tz_--ChtirC(r4O ­245' ESL« t_o C--(2,W- i3 ��U� T'HuF /uC A- t-z2 <br /> 5'711-< $ltN-�� P�w.� 7 N ,p er �c •�r3-N�.� c�(K�,o a sQAt r 0.2 <br /> [7 SS� �-5�7z ftL:f}IZrL� LK <br /> Page 3 of 3 03/01 <br />