Laserfiche WebLink
iteAe.dress: 1100 S MAIN STREET Date nfTestuiglServrcing: _W v <br /> F. In-Tank Gauging/ SIR Equipment: Check this box if tank gauging is used only for inventory control. <br /> 1100 S MAIN STREET 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 /> Complete the following checklist: <br /> p Yes El- 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 /> Q Yes Q No* Was accuracy of system product level readings tested? <br /> Q. <br /> Yes 1 No* Was accuracy of system water level readings tested? <br /> Yes No* Were all probes reinstall e d prop erly? <br /> 0 Yes [] No* Were all items on the e quip ment manufacturer's maintenanc e che cklist c omplete d? <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 following checklist: <br /> es P No* For equipment start-up or annual equipment c cation, was a leak simulated to verify LLD performance? <br /> L7 NIA (Checkoff that apply) Simulated leak rate: ,_ g.p.h.l-' [3 0.1 g.p.h.2; L7 0.2 g.p.h.� <br /> Notes: 1. Required for equipment start-up certification and annual certification. <br /> 2. Unless mandated by local agency, certification required only for electronic LLD start-up. <br /> Q Yes A No* Were all=s confirmed operational and accurate withinregulatoryrequirements? <br /> es. No* Was the testing apparatus properly calibrated? <br /> es [] No* For mechani calLLD s, doestheLLD restrict pro duct flow ifitdetectsaleal? <br /> N!A <br /> p Yes UZ <br /> For electronic LLD s, does the turbine automatically shut off if the LLD detects a leaf? <br /> Yes 0 No* For electronic L.LDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> !A or disconnected? <br /> Yes 0 No* For electronic LLD s, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br /> b-ITIA or fails ate st? <br /> [] <br /> Yes . <br /> No* For electronic LLD s,have all accessible wiring connections beenvisuallyinspected? <br /> /A <br /> es 13 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 correcte d. <br /> H. Comments: I <br /> xi s Le ni <br /> I <br /> i <br /> 1 <br /> I <br /> s <br /> k <br /> Page 3 of 3 03.01 <br />