COMPLIANCE INFO_2012-2018 - Laserfiche WebLink

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F. In -Tank Gauging / SIR Equipment: ® Check this box if tank gang ng is used only for inventory control. ❑ Check this box if no tank gauging or SIR equipment is installed. This section must be completed If In -tank gauging equipment Is used to perform leak detection monitoring. Complete the following checklist: ❑ Yes ❑ No* Has all Input wiring been inspected for proper entry and termination, including testing for ground faults? L7 Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? ❑ Yes ❑ No* Was accuracy of system -product level readings tested? [] Yes ❑ No* Was accuracy of system water level readings tested? ❑ Yes ❑ No* Were all probes reinstalled properly? ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? In Section H, below, describe how and when these deficiencies were or will be corrected. ine Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. P.u.....lnt'n 66n fnllnuAnn n6un411e}• ® Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) ❑ N/A Simulated leak rate: ® 3 g.p.h.; ❑ 0.1 g.p.h; ❑ 0.2 g.p.h. ® Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? ® Yes ❑ No* Was the testing apparatus properly calibrated? ® Yes ❑ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ❑ N/A _ ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? _ ® N/A ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? ® NIA ❑ Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? ® NIA ❑ Yes ❑ No* For electronic LLDs, have all accessible wiring connections been visually inspected? ® N/A ® Yes ❑ No* Were all Items on the equipment manufacturer's maintenance checklist completed? In Section H, below, describe how and when these deficiencies were or will be corrected. H. comments: Leak Detectors DSL 160 6 26 13 PASS DSL B 150 FAILED 91 140 FAILED 87 140 3 26 21 PASS RED DSL 160 3 26 14 PASS DSL 2 170 4 26 12 PASS Monitoring System Certification Page 3 of 4 2/21/07