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AFFORDA—TEST <br />F. lo -Think Gauging / Stlt Fyttipntent: <br />12097940112 P.06 <br />14'(- iicck this box if tank gauging is used only for inventory cmii.- <br />U Check this box if no tank gauging o!.- SIR equipment is installe. j <br />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. <br />Complete the following checklist: _ <br />13 Yes <br />❑ No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />E) es <br />❑ No* <br />Were all tank gauging probes visually inspected for damage and resiolue buildup? <br />❑yes <br />❑ No* <br />Was accuracy of system product level readings tested? <br />❑ Yes <br />❑ No* <br />Was accuracy of system water level readings tested? <br />❑ Yes <br />❑ No* I <br />Were all probes reinstalled properly? W_ <br />❑ Yes7 <br />Q No* 1 <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In the Section. Il, below, describe how and when these deficiencies were or will be corrected. <br />G. Line Leak Detectors (LLD): U Check this box if LLDs are not installed. <br />Cmmnlete the followine checklist: <br />U Yes <br />❑ No* <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD ;perforrz c <br />1-0 <br />p NIA <br />(Check all that apply) Simulated leak rate: ❑ 3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.7 g.p.h. <br />❑ Yes <br />❑ Ne <br />Were all LLDs conformed operational and accurate within regulatory requirerrments7 <br />Yes <br />❑ No* <br />Was the testing apparatus property calibrated? <br />U Yes <br />❑ No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />❑ NIA <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />U N/A, <br />U Yes <br />❑ No* <br />For electronic LLDs, does tite turbute automatically shut off if ally, portion of the t,nordtoring system Is dbabl< <br />U NIA, <br />or disconnected? <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring sl t i <br />❑ NIA <br />tnaltilnctions or fails a test? _ <br />❑ Yes <br />O No* <br />or electronic LLDs, have all accessible wiring connections been visually inspected? <br />U NIA <br />❑ Yes j <br />❑ No* I <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />a� <br />* In the Section <br />H. <br />below, describe how and when these deficiencies were or will be corrected. <br />H. Comments• <br />V <br />Page 3 of 3 <br />"ll <br />