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F. In-Tank Gauging/SIR Equipment: ❑ C ack this box if tank gauging is used only for inventory control. <br /> 3 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 /> ❑ Yes ❑ No* I 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 /> ❑ 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 reinstalled properly? <br /> O Yes 1 ❑ No" I Were all items on the equipment manufacturer's maintenance checklist completed? <br /> a' 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 /> Com lete the following checklist: <br /> Er—Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br /> ❑ N/A (Check all that apply) Simulated leak rate: C?'-.p.h.; ❑ 0.1 g.p.h; ❑ 0.3 g.p.h. <br /> ❑ Yes l2r-ITo!" Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> 2—yes ❑ No* Was the testing apparatus properly calibrated? <br /> C3—Yes ❑ No* For mechanical LLDs,does the LLD restrict product flow if it detects a lcak? <br /> ❑ N/A <br /> ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> 2—N/A <br /> ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> l3'N/A or disconnected? <br /> ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions <br /> !YN/A or 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 thesedeficiencies were or will be corrected. <br /> H. Comments: 8"9 11" 1-:291L�00 �/C--'9e <br /> g� c'f�4�;)r� [✓! 77� t/i9,� z s.)o 7' <br /> LO s2 K s — -Cc-21`2 e— c <br /> Page 3 of 3 03/01 <br />