COMPLIANCE INFO_2013-2018 - Laserfiche WebLink

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J F. In -Tank Gauging I SIR Equipment: ❑ Check this box if tank gauging is used only for inventory control. ❑ Check this box if no tank gauging or SIR equipment 'iW � an This section must be completed if in statY -tank gauging equipment is used to perform leak detection monitoring. s `' ` Complete the following checklist: ANN 9 9. 2W ❑ 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? 'Pik . 1a ❑ Yes ❑ No' Was accuracy of system product level readings tested? ❑ Yes ❑ No' Was accuracy of system water level readings tested? ❑ Yes ❑ No' Were all probes reinstalled properly? ❑ Yes ❑ No` Were all items on the equipment manufacturer's maintenance checklist completed? ' In Section H, below, describe how and when these deficiencies were or will be corrected. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. ® Yes ❑ No' For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) ❑ NIA Simulated leak rate: ® 3 g.p.h.: ❑ 0.1 g.p.h , ❑ 0.2 g.p.h. ® Yes ❑ No' Were all LLDs confirmed operational and accurate within regulatory requirements? ® Yes ❑ No' Was the testing apparatus properly calibrated? ® Yes ❑ 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? ® N/A ❑Yes ❑ No' For electronic LLDs, does the turbine automatically shut off a any portion of the monitoring system is disabled or disconnected? ® N/A ❑ Yes ❑ No' For electronic LLDs, does the turbine automatically shut off H any portion of the monitoring system malfunctions or fails a test? ® N/A E]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 Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: 87 120 3 24 21 PASS 91 130 3 26 21 PASS DSL 140 3 30 23 PASS Monitoring System Certification Page 3 of 4 1;i 1'0?