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IF. In -Tank Gauging /SIR Equipment: ❑ gheck this box if tank gauging is used only for inventory control. <br />Q 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 />Comnlete the followinu checklist: <br />❑ Yes <br />❑ No* <br />Has all input wiring been inspected for proper entry and termination. including testing for vrnmirl fanitg� <br />❑ Yes <br />❑ No* <br />Were all tank gauging probes visually inspected for damage and residue 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* <br />Were all probes reinstalled properly? <br />❑ Yes <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance c'heckiizt completed? <br />III uIe aeuwu n, ueiow, uescriue now ana wnen mese aenctencies were or will be corrected. <br />G. Line Leak Detectors (LLD): <br />Comalete the following checklist: <br />❑ Check this box if LLDs are not installed. <br />YcN <br />❑ No* <br />❑ N/A <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br />(Check all that apply) Simulated leak rate: aT_g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />Ur Yes <br />❑ No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Yes <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />Ua'Yes <br />❑ No* <br />❑ N/A <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />❑ Yes <br />❑ * <br />16N/A <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />❑ Yes <br />❑ No* <br />L"/A <br />For electronic LLDs, does the- :­bine automatically shut off if any portion of the monitoring system is disabled <br />or disconnected? <br />❑ Yes <br />❑ No* <br />Dli/A <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br />or fails a test? <br />❑ Yes <br />❑ <br />r3 N/A <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />Yes <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist com�leted? <br />m in the aecaon it, oelow, aescrioe now ana wnen mese aettciencies were or will be corrected. <br />H. Comments: <br />Page 3 of 3 <br />03101 <br />