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F. In-Ttank (saatgi9➢glCg: Lqui taaent: Check this box if tank i.;ing is used only for inventory control. <br />1:1 Check this box if no t: cubing or SIR equipment is installed. <br />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. <br />— : �nniFr ipfp flip Fn U��zueva,r r9ann►�lic4 <br />O Yes <br />❑ <br />No* <br />Has all input wiring been ..spected for proper entry and termination, including testing for ground faults? <br />❑ Yes <br />❑ <br />No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />Cl Yes <br />❑ <br />No* <br />Was accuracy of system product level readings tested? <br />❑ Yes <br />❑ <br />No* <br />Was accuracy of system water level readings tested? <br />❑ Yes <br />❑ <br />No* <br />Were all probes reinstalled properly? <br />❑ Yes <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In the <br />Section H, below, describe how and when these deficiencies were or will be corrected. <br />G. Line <br />Leal[ (Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />C m tete the following checklist: <br />IAYes <br />❑ No* <br />For equipment start-up or annual equipment p rtification, was a leak simulated to verify LLD performance? <br />❑ N/A <br />(Check al/ that apply) Simulated leak rate: 3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />Yes <br />❑ No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Yes <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />Yes <br />❑ No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />❑ N/A <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />IMP N/A <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />@ N/A <br />or disconnected? <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system <br />-OP <br />N/A <br />malfunctions or fails a test? <br />❑ Yes <br />❑ No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />M N/A <br />Yes <br />❑ No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In the Section <br />H, below, describe how and when these deficiencies were or will be corrected. <br />H. Comments: <br />Page 3 0113 03101 <br />