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I4'. In -Tank Gauging / SIR I+ qu eot: 10 Check this box if tank augirg is used only for inventory a ontr^.1. <br />❑ 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 />Camnlete the followinv rheelrli.f. <br />❑ Yes <br />❑ No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <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 ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br />.... ... «..,,. UVV UJAU WRIVIA Lutme uenciencles were or will be corrected. <br />G. Line Leak Detectors (LLD): <br />Camnlete the fallowina ehPA-1Be4• <br />❑ Check this box if LLDs are not installed. <br />Ut Yes <br />❑ No* <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br />❑ N/A <br />(Check all that apply) Simulated leak rate: &3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />IQ Yes <br />❑ No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />JQ Yes <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />Yes <br />❑ No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />❑ N/A <br />❑ Yes <br />❑ No* <br />N/A <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />❑ Yes <br />❑ No* <br />N/A <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />disconnected? <br />or <br />❑ Yes <br />❑ No* <br />N/A <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br />fails <br />or a test? <br />❑ Yes <br />❑ No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />N/A <br />Yes <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* Tn +hn Cnniinn <br />U <br />F.nl.,... <br />•... ...... ...... s.........� �e ua aaa °cuc ec, were ur win De corrected. <br />H. Comments: <br />Page 3 of 3 03/01 <br />