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i <br />F. In -Tank Gauging / SIR Equipment: V Check this box if tank gauging is used only for inventory control. <br />r Check this box if no tank gauging or SIR equipment is Pnt O L 0 15 <br />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. <br />Complete the following checklist: <br />e Yes <br />r No* <br />as all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />Yes <br />r No* <br />Nere all tank gauging probes visually inspected for damage and residue buildup? <br />r Yes <br />r No* <br />Nas accuracy of system product level readings tested? <br />A' Yes <br />No* <br />Nas accuracy of system water level readings tested? <br />, Yes <br />No* <br />Were all probes reinstalled properly? <br />Yes <br />rNo* <br />ere all items on the equipment manufacturer's maintenance checklist completed? <br />* In the Section H, below, describe how and when these deficiencies were or will be corrected. <br />G. Line Leak Detectors (LLD): r Check this box if LLDs are not installed. <br />Complete the following checklist: <br />q, Yes <br />r No* <br />For equipment start-up or annual equipment certificatio,,nc was a leak simulated to verify LLD performance? (Check all that <br />PPIY) Simulated leak rater 3 g.p.h.; r o.1 g.p.h; l 0.2 g.p.h. <br />;, N/A <br />* Yes <br />r No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />*° Yes <br />r No* <br />Was the testing apparatus properly calibrated? <br />Yes <br />r No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />• N/A <br />r Yes <br />r No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />N/A <br />•: Yes <br />r No* <br />For electronic LLDs that are programmed for positive shut down, does the turbine automatically shut off if any portion of the <br />onitoring system is disabled or disconnected? <br />': N/A <br />•: Yes <br />r No* <br />For electronic LLDs that are programmed for positive shut down, does the turbine automatically shut off if any portion of the <br />monitoring system malfunctions or fails a test? <br />,' N/A <br />• Yes <br />r No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />N/A <br />r; Yes <br />r No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />* In the Section H, below, describe how and when these deficiencies were or will be corrected. <br />Page 3 of 3 12/07 <br />