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09/19/2001 11:15 <br />l7 Check this box if tank gauging is used onlY for inventory control. <br />F. In -Tank Gauging / SIR Equipment: ❑ Check this box if no tank pumng or SIR equipment is installed. <br />This section must be completed if an -tater gauging equipment is used to perforl* leak detection monitoring. <br />2094683433 <br />FIFTH FLOC2 <br />PAGE 04 <br />Cote Tete the fd1lowin checklist: far proper entry and termtttanott, tnciitding testing for ground faults? <br />'a4l yes O No" Has all input wiring been inspected <br />* robes visually inspected for damage and residue buildup? <br />�] Yes O No Were all tank ¢ugiag probes <br />S Yes D No* Was accuracy of systcm product level readings tested? <br />Yes O No* Was accuracy of system water level readings tested? <br />Ci Yes Q No* Were all probes reinstalled properly? letd? <br />yes ❑ No* Were all items on the egttipment manufacturer's maintenance checklist c mp <br />In the Section H, below, describs botiv and when these deficiencies were or wiU be corrected. <br />G. Line Leak Detectors (LLD): ® Check this box if LLDs are not installed. <br />to late�Ihe <br />For O;�=ntpum_ipeYesC�dletkt3pj_h utt <br />$ plea®so$ p h to verify LLD p <br />erformanee? <br />Yes <br />Yes <br />Yes <br />® Yes <br />O No* <br />Q No* <br />O Ne <br />❑ NIA <br />C1 No` <br />Were all LLDs cottfirmed operational and accurate within regulatory rcqutren <br />Was the testing apparatusproPcrly calibrated? <br />For n cchanical LLI7s, docs the LLD restr►ct product flow if it detects I tealcr <br />for electronic LI,Ds, does the to iDe automatically shut off if the <br />g! N/t1 <br />C) Yes ❑ No* For electronic LLDs, docs the turbine ttutotnatically shut o any <br />{ N/A or disconnected? <br />O Nthe turbine automatically shut off if any l <br />0 yes o* For electronic LLDs, does <br />'I NIA or fails a test? connectiotzs been vi <br />El yes O No- For electronic LLDs, have all accessible wising <br />`O' NIA11 <br />tl Yes c7 No" Were all items on the equtpmsnt rtaanufacturcr's maintenance ch <br />er l <br />* In the Section N, belotiv, describe how and tivhen these deficiencies were or will be <br />detects a leak'? <br />of the monitoring system is disabled <br />of the moVtonng system malfunctions <br />inspected? <br />completed? <br />H. Comments: a o rr � u o <br />9-7 <br />3�' -moo von <br />i <br />i i ems✓ S -/0 fs"� <br />43/0) <br />Page 3 of 3 <br />