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h-ox il taiik gau'gic.L i;" used olliv l"DI.it.,Vi'J"i f)J-:1 <br /> U Cheek this box if no tank gauging or SIR equipment is ijistallt.d. <br /> This section must be completed if in-tank gauging equipment is used to perforni leak detection monitoring. <br /> Complete the follow i9lLcheeldist: <br /> U Yes Q No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br /> Ll Yes Q No* —Were all tank gauging probes visually inspected for damage and residue buildup? <br /> Ll Yes 0 No* Was accuracy of system product level readings tested? <br /> • Yes U No* Was accuracy of system water level readings tested? <br /> • Yes LJ No* Were all probes reinstalled properly? <br /> Q Yes I Q 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): El Check this box if LLDs are not installed. <br /> Comp]_d.e the following checklist: <br /> L-r-Yes Ll No* For equipment start-up or annual equipmentc0ifleati-6n, was a leak simulated to verify LLD performance? <br /> Ll N/A (Check all that apply) Simulated leak rate: ET-3 g.p.h.; 0 0.1 g.p.h; Ll 0.2 g.p.h. <br /> ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> 0 No* Was the testing apparatus properly calibrated? <br /> Ld Yes Ll No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> U N/A <br /> LJ Yes LJ No!.- For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> U N/A <br /> -U Yes LJ No For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> ITNIA or disconnected? <br /> n Ll Yes -0'* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions <br /> N/A or fails a test? <br /> L3 Yes Q No* For electronic LLDs,haveI all accessible wiring connections been visually inspected? <br /> Lf N/A <br /> Ll"Yes L3 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: J,(A <br /> 61 �p <br /> 4 :5yk—y, cE`A, <br /> Page 3 of 3 03101 <br />