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rer in rLUUM rHur- U14 <br /> a a <br /> F. In-Tank Gauging I SIR Equipment: O Check this box if tank gauging is used only for inventory control. <br /> O 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 /> Com lets the foll ing checklist: <br /> Yes ® No* Has all input wiring been inspected for proper entry and t mnirt,3tion, including testing forground faults'? <br /> O Yes 0 No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> Yes O Noy Was accuracy of system product level readings tested? <br /> Yes 0 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 H,below,describe hoer and when these deficiencies were or will be corrected. <br /> G. Line Leak Detectors (LLD): Q Check this box if LLDs are not installed. <br /> Complete the foliowin checklist: <br /> .0 Yes O Noy For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br /> O N/A (Check all that apply) Simulated leak rate: j 6 g.p.h.; O 0.1 g.p.h; 0 0.2 g.p.h. <br /> Yes Q No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> Yes Q No* Was the testing apparatus properly calibrated? <br /> Ycs O No" For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> ❑ N/A <br /> O Yes O No" For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> N/A <br /> O Yes O No* For electronic LLDs, does the turbine automatically shat off if any portion of the monitoring system is disabled <br /> ,0"N/A or disconnected'? <br /> Q Yes Q No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions <br /> N/A or fails a test? <br /> rJ Yes O Noy for electronic LLDs,have all accessible wiring connections been visually inspected? <br /> ,�2"N/A <br /> 1a'Yes ® No* Were all items on the equipment manufacturer's Maintenance checklist completed? <br /> * In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: <br /> Page 3 of 3 03101 <br />