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r it in r Luum h'HUt C14 <br />F. In -Tani: Gauging/ 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 />Complete the folloerin checklist: <br />Yes O No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />Yes 0 No* Were all tank- gauging probes visually inspected for damage and residue buildup? <br />Yes O No* Was accuracy of system product level readings tested? <br />Yes O No* Was accuracy of system water level readings tested? <br />Yes O No* Were all probes reinstalled properly? <br />;' Yes I Q No* I Were all items on the equipment ufacturer's maintenance checklist completed? <br />* In the Section K, below, describe how and when these deficiencies were or will be corrected. <br />G. Line Leak Detectors (LLD): Ip Check this box if LLDs are not installed. <br />Comolete the followino checklist! <br />O Ycs <br />O No* <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD perfonrssnce? <br />O N/A <br />(Check all that apply) Simulated leak rate: O 3 g.p.h.; 0 0.1 g.p.h ; O 0.2 g.p.h. <br />❑ Yes <br />0 No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Q Yes <br />Cl No* <br />Was the testing apparatus properly calibrated? <br />O Yes <br />O No" <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />O N/A <br />Q Yes <br />❑ No* <br />For electronic LLD$, does the turbine automatically shut off if the LLD detects a leak? <br />O N/A <br />❑ Yes <br />O No* <br />For electronic LLDs, does cite turbine automatically shut off if any portion of the monitoring system is disabled <br />O N/A <br />or disconnected? <br />Q Yes <br />O No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system n-alfianc tions <br />O N/A <br />or fails a test? <br />O Yes <br />0 No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />Q N/A <br />❑ 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 />H. Comments; <br />Page 3 of 3 090 1 <br />