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F. In-Tani. Gauging/SIR I <br /> prnent: Check this box iftann gauging inQ <br /> ❑ Check this box if no tank gaugingis Lsed Only or SIR equipment isol inventory <br /> Iled control. <br /> This section must be completed if in-tank gauging equipment is used toerform leak k detection monitoring. <br /> Complete the foMWimg checklist- <br /> ❑ Yes ❑ No* Has all input wiring been inspected for proper entry and termination, including testing <br /> ❑ Yes ❑ No Were all tank gauging probes visually inspected for damage and residue buildgp? b for ground faults? <br /> ❑ Yes ❑ No Was accuracy of system product level readings tested? <br /> ❑ Yes ❑ No* Was accuracy of system water Level readings tested? <br /> ❑ Yes ❑ No* Were all probes reinstalle11 d properly? <br /> ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> *In the Section H,below,describe how Ind when these deficiencies were or will be corrected. <br /> G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br /> Co fete gie followin checklist: <br /> Yes No* For equipment start-up or annual equipment ification, was a leak simulated to verify LLD erforma <br /> 11 N/A (Check all that apply) Simulated leak rate: 3 <br /> P.h-; ❑0.1 g.p.h; ❑0.2g-P•h P nce. <br /> Yes ❑ No* Were all LLDs confirmed operational and 13accurate within regulatory requirements? <br /> Yes No* Was the testing apparatus properly calibrated? <br /> Yes ❑ No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> ❑ N/A <br /> ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> N/A <br /> ❑ Yes ❑ No For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> N/A or disconnected? <br /> ❑ Yes ❑ o* For electronic LLDS, does the turbine automatically shut off if any portion <br /> malfunctions or faof the monitoring system <br /> N/A fails a test? <br /> ❑ Yes ❑ o* For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> /A <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 /> H. Comments: ,f� 7 G 2 f�>�cy� �G L/✓�h <br /> XY <br /> Page 3 of 3 <br /> 03101 <br />