COMPLIANCE INFO_2003-2008 - Laserfiche WebLink

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Mooiteri.ng System Certification Site Address: '° "� ff�' y� ; Gi Date of Testing/Servicing: / /Q,. ! c F. In-Tank Gauging/ SIR Equipment: Teck this box if tank gauging is used only for inventory control. ❑ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: ❑ Yes ❑ No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? ❑ Yes 13 No* Were all tank gauging probes visually inspected for damage and residue buildup? ❑ Yes C3 No* Was accuracy of system product level readings tested? ❑ Yes '❑ No* Was accuracy of system water level readings tested? ❑ Yes ❑ 'No* Were all probes reinstalled properly? ❑ Yes 1 ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below,describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. Co tete the following checklists Gf Yes ❑ No* For equipment start-up or annual equipment ce ' ecation, was a leak simulated to verify LLD performance? ❑ N/A (Check all[ha!apply) Simulated leak rate: Cr3 g.p.h.; ❑0.1 g.p.h ; ❑ 0.2 g.p.h. Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? 1;ryles ❑ No* Was the testing apparatus properly calibrated? Ed Yes 1 ❑ No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? ❑ N/A ❑ Yes ❑ o* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? } , CI'N/A ❑ Yes o* ❑`NI For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled /A or disconnected? ❑ Yes ❑ o* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system Ed /A malfunctions or fails a test? ❑ es ❑ o* For electronic LLDs,have all accessible wiring connections been visually inspected? Ul N/A Yes ® No* Were all items on the equipment manufacturer's maintenance checklist completed? In the Section H, below,describe how and when these deficiencies were or will be corrected. H. Comments: