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i <br />e <br />F. In -Tank Gauging / SIR Equo ent: <br />XCheck 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 />Comnlete the fallnwina rlpnrkliat- __fi, <br />-•• _••.• .�............Al ...,.4...9 "-z - uvea "epee rmucHa 612G3C Ueil67CnCIC9 were or will De Correctea. <br />G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />Comnlete the foilowina rherklict- <br />Yes <br />_.. .... .. <br />No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />❑ No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />F❑ <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 />Id Yes <br />❑ No* <br />Were all probes reinstalled properly? <br />=0 <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />-•• _••.• .�............Al ...,.4...9 "-z - uvea "epee rmucHa 612G3C Ueil67CnCIC9 were or will De Correctea. <br />G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />Comnlete the foilowina rherklict- <br />Yes <br />_.. .... .. <br />❑ No* <br />For equipment start-up or annual equipment c rti ication, 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 />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 />Id 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 />dN/A <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />g N/A <br />or disconnected? <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br />N/A <br />or fails a test? <br />❑ Yes <br />❑ o* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />N/A <br />Yes 1 <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />--1 .,..,.,,,, ... o. ■ ap,c MAU" "RAU TV11Vli LAI%ZC UcuCjCUCle3 were or wilt De corrected. <br />H. Comments: <br />Page 3 of 3 03/01 <br />