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TRACY TRUCK STOP 209 BSZ 6307 04/08/04 01:09pm P. 006 <br />F. In -Tank Gauging /'SIR Equipment: M-Cli'leck this box if tank gauging is used only fbr inventory control. <br />this box if no tank gauging or SIR 6qiiipment is installed. 0 Cheek al ed. r <br />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring, <br />raninlete the fallowinff rheekiliatt <br />C] 'Yes <br />0 No* <br />Has all input wiring been inspected for proper entry and termination, including Lasting far ground faults?=� <br />U Yes <br />Q N&,' <br />Were all tank gauging probes visually inspected .for damage and residue buildup? <br />J Yes <br />13 No* <br />Was accuracy of system product level readings tested? <br />Q Yes <br />13 No* <br />Was accuracy of system water level readings tested? <br />0 Yes <br />0 Nb* <br />Were all probes reinstalled properly? <br />Q Yes <br />13 No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />I" UM a4m 3wil Eli uctow, a=rj c now or woen [nese eenciencies were or will ne correetw. <br />G. Line Leak Detectors (LLD); Q Check this box if LLDs are not installed. <br />ramnlPte the rodinwina PhAm4rhot. <br />3 -Yes <br />El No* <br />0 N/A <br />For equipment start-up or annual equipment c cation. was a leak simulated to verify LLD performance? <br />(Checkall that apply) Simulated leaf: rate: El 3 g.p,h., U 0.1 g.p.h; L) 0.2 g.p1. <br />Or Yes <br />C] No* <br />Were all 1,LDs confirmed operational and accurate within regulatory requirements? <br />Z—Yes <br />L3 N&* <br />Was the testing apparatus properly calibrated? <br />YYes <br />0 No* <br />0 N/A <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />Q Yes <br />U No* <br />EX"NIA <br />For electronic LLDs, does the turbine automatically shut off if the UD detects a leak? <br />Q Yes <br />Q No* <br />eNIA <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />or disconnected? <br />Cl Yes <br />Q No* <br />Ur'NIA <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring systern malfunctions <br />or fails a test? <br />Q Yes <br />®}No* <br />LT N/A <br />For electronic LLD&. have all accessible wiring connections been visually inspected? <br />6 Yes <br />Q No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />- in me =Uon M below, aescriDe flow and wnen these denciencies were or will be corrected. <br />Page 3 of 3 03/01 <br />