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F. In -Tank Gauging / SIR Equipment: eCh a tins box if tank gauging is used only for inventory control. <br />❑ C'neck 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 />Complete the followine checklist: <br />Q 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 residne buildup? <br />Q Yes <br />U No* <br />Was accuracy of system product level readings tested? <br />D Yes <br />0 No* <br />Was aceuracylof system water level readings tested? <br />❑ Yes <br />❑ No* <br />Were all probes reinstalled properly? <br />Q Yes <br />❑ No* <br />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 />G. Line Leak Detectors (LLD): n Check this box if LLDs are not installed. <br />Complete the following checklist: <br />Yes <br />❑ No* <br />0 N/A <br />For equipment start-up or annual equipment 'on, was a leak simulated to verify LLD performance? <br />(Check all that apply) Simulated leak rate: 03❑ 4.1 g.p.h ; D 0.2 g p.h. <br />Yes <br />❑ No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />er'Yes <br />Q No* <br />Was the testing apparatus properly calibrated? <br />Yes <br />❑ No* <br />Q N/A <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />❑ Yes <br />❑ W <br />@'" NIA <br />For electronic i I.Ds, does the turbine automatically shut off if the LLD detects a leak? <br />❑ Yes <br />Q lam* <br />EX N/A <br />For electronic U -M, does the turbine automaticafly shut off if any portion of the monitoring system is disabled <br />or disconnected? <br />❑ Yes <br />Q No* <br />®' N/A <br />For electronic T. l.Ds, does the turbine automatically shut off of any portion of the monitoring system malfimcdons <br />or fails a test? <br />❑ yes <br />Q <br />C� N/A <br />For electronic LLDs, have all accessible wiring connections been visua3ly inspected? <br />Yes <br />❑ No* <br />Were ail its on the equipment manufacturer's maintenance checklist completed? � <br />* to the Section $ below, describe how and when these deficiencies were or will be corrected. <br />H. Comments, <br />Page 3 of 3 <br />5 <br />03/01 <br />