COMPLIANCE INFO_2004-2012 - Laserfiche WebLink

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Mon0cri.ng System Certification 0 0// Site Address: _ Date of Testing/Servicing: / /b p F. In -Tank Gauging/ SIR Equipment:Check this box if tank gauging is used only for inventory control. ❑ heck 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 ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? ❑ Yes ❑ No* Was accuracy of system product level readings tested? ❑ Yes ❑ No* Was accuracy of system water level readings tested? ❑ Yes L3No* ❑ Yes Were all probes reinstalled properly? ❑ 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. G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. 4, jWplete the following checklist: * in the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: ❑ No* For equipment start-up or annual equipme rtification, was a leak simulated to verify LLD performance? ❑ N/A (Check all that apply) Simulated leak rate: 3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. Wes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? ❑ No* Was the testing apparatus properly calibrated? ❑ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ❑ N/A ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? AR N/A ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled N/A or disconnected? ❑ Yes No* For electronic LLDs, does (lie turbine automatically shut off if any portion of the monitoring system N/A malfunctions or fails a test? ❑ Yes ❑ No* For electronic LLDs, have all accessible wiring connections been visually inspected? 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: