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F. In -Tank Gauging / SIR Equipment: P 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 installed. <br />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. <br />Complete the following checklist: <br />r Yes <br />r No* <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />Yes <br />r No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />r Yes <br />r No* <br />Was accuracy of system product level readings tested? <br />r Yes <br />r No* <br />Was accuracy of system water level readings tested? <br />r Yes <br />d No* <br />lWere all probes reinstalled properly? <br />f Yes <br />No* <br />Were all items on the equipment manufacturer?s maintenance checklist completed? <br />" _ _ Oil uE uw, uCa,�i iue mw mw when mese oericiencies were or wiii be corrected. <br />G. Line Leak Detectors (LLD): r- Check this box if LLDs are not installed. <br />Complete the following checklist: <br />r# Yes <br />r No* <br />For equipment start-up or annual equipment certification was a leak simulated to verify LLD performance? (Check all that <br />W3 <br />r N/A <br />apply) Simulated leak rate: g.p.h.; r 0.1 g.p.h; 0.2 g.p.h. <br />is 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 />r Yes <br />C No* <br />For mechanical LLDs, does the LLD restrict product Flow if it detects a leak? <br />r* N/A <br />iF Yes <br />r No* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />N/A <br />r Yes <br />r No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br />N/A <br />Yes <br />r No* <br />For electronic LLDs, does the turbine automatically shut off If any portion of the monitoring system malfunctions or fails a test? <br />N/A <br />C." Yes <br />r No* <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />N/A <br />is Yes <br />r No* <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />::. _ ae 'ui. ", uC!uw, ueslr10e nuw dna wnen these deficiencies were or win be corrected. <br />Page 3 of 3 12/07 <br />