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A <br />F' In -Tank Gauging/ SIR Equipment: <br />Q Check this box if tank: gauging is used o®niy for inventory control. <br />Q Check this box if no tank gauging or Silt equipment is installed. <br />This section must be completed if in -tante gauging equipment is used to perfonn leak detection monitoring. <br />Cotmmnlete the following cheek list! <br />Yes <br />Q No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />Yes <br />1 Q No* Were all tank gauging probes visually inspected for damage and residue buildup? <br />lEr Yes <br />Q No* <br />Was accuracy of system product level readings tested? <br />es <br />Q No* <br />Was accuracy of system water level readings tested? <br />Yes <br />Q No* <br />Were all probes reinstalled property? <br />Yes <br />Q No* <br />Were all 'stems on the equil3mcmt manufacturer's maintenance checklist completed? <br />ani site Jci:ilUil 27y UCBU", iEC96:riuc UOW allu WUCU CLIC= oec$ctencnes were or wtu $e corrected. <br />G. Line Leak Detectors (LLD): Q Check this box if LLDs are not installed. <br />Complete the foiiowine checklists <br />u Yes G No* <br />Q NIA <br />Q Yes , Q No* <br />Q Yes Q No - <br />0 Yes Q N6* <br />Q l&/A <br />Q Yes Q No* <br />_ Q NIA <br />Q Yes Q' No* <br />Q NIA <br />Q Yes Q No* <br />Q NIA <br />rQ Yes i Q No* <br />Q N/A <br />Q Yes Q No* <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br />(Check all that apply) Simulated leaf: rate. Q "s g.p.h.; Q 0.1 g.p.h ; Q 0.2 g.p.h. <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />Was the testing apparatus properly calibrated? <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak. <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />Fix electronic LLDs, does the mu -brine automatically shut off of any portion of site monitoring system is disabled <br />or disconnected? <br />For electronic LLDs, does the turbine automatically stmt off if any portion of the monitoring system malfunctions <br />or ails a test? <br />For electronic LLDs, have all accessible wising connections been visually inspected? <br />Were all items on the equipment t ma&acmaer's maintenance checklist completed? <br />* In the Section H, below, describe how and when these deficiencies were or will be corrected. <br />A. Comments: <br />Page 3 of 3 03101 <br />