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I <br />F. lop I-anic Gauging / SIR EgUI P eut: <br />Check this box if tank gauging is used only for inventory contaol. <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 perforin leak detection monitoring. <br />Complete the following; checklist: <br />❑ Yes ❑ No* 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 />❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In the Section II, below, describe how and when these deficiencies were or will be corrected. <br />G. Line Leak Detectors (LLD): this box if LLDs are not installed. <br />E <br />Camnlete the fnllaWina rh�.�.lrt:�t• /e% <br />Yes <br />❑ No* <br />For equipment start-up or annual equipment ertification, was a leak simulated to verify LLD performance? <br />13 N/A <br />(Check all that apply) Simulated leak rate: 3 g.p.h.; L30.1 g.p.h ; L30.2 g.p.h. <br />,Yes <br />L3No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Yes <br />El 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 />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />❑ N/A <br />Yes <br />❑ No* <br />For electronic LLDs, does the turbine autom atically shut off if any portion of the monitoring system is disabled <br />13 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 />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />Yes <br />❑ No* <br />❑ N/A <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />Yes I <br />❑ No* <br />* In the Section <br />H_ <br />heinw_ apc...-aho 16n —A _1L__ <br />H. Comments: <br />v Xa U, W AN VC CVrrecleu. <br />1 <br />Page 3 of 3 03101 <br />